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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Hepatitis B virus transmission by blood transfusion during 4 years of individual-donation nucleic acid testing in South Africa: Estimated and observed window period risk
Transfusion, Volume 52, No. 4, Year 2012
Notification
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Description
Background: Since October 2005, a total of 2,921,561 blood donations have been screened by the South African National Blood Service for hepatitis B virus (HBV) by individual-donation nucleic acid testing (ID-NAT). Over 4 years, 149 hepatitis B surface antigen-negative acute-phase HBV NAT-positive donations were identified (1:19,608). The lookback program identified one probable HBV transmission. Study design and methods: The complete genomes of HBV isolated from the donor and recipient were sequenced, cloned, and analyzed phylogenetically. The HBV window period (WP) transmission risk was estimated assuming a minimum infectious dose of 3.7 HBV virions and an incidence rate correction factor of 1.34 for transient detectability of HBV DNA. Results: Of 149 acute-phase HBV NAT yields, 114 (1:25,627) were classified as pre-antibody to hepatitis B core antigen (anti-HBc) WP and 35 (1:83,473) as post-anti-HBc WP. The acute-phase transmission risk in the HBV DNA-negative pre- and post-anti-HBc WPs (of 15.3 and 1.3 days, respectively) was estimated at 1:40,000 and 1:480,000, respectively. One HBV transmission (1:2,900,000) was identified in a patient who received a transfusion from an ID-NAT-nonreactive donor in the pre-anti-HBc WP. Sequence analysis confirmed transmission of HBV Subgenotype A1 with 99.7% nucleotide homology between donor and recipient strains. The viral burden in the infectious red blood cell unit was estimated at 32 (22-43) HBV DNA copies/20 mL of plasma. Conclusion: We report the first known case of transfusion-transmitted HBV infection by blood screened using ID-NAT giving an observed HBV transmission rate of 0.34 per million. The estimated pre-acute-phase transmission risk in the ID-NAT screened donor population was 73-fold higher than the observed WP transmission rate. © 2011 American Association of Blood Banks.
Authors & Co-Authors
Vermeulen, Marion
South Africa, Weltevreden Park
South African National Blood Service
South Africa, Johannesburg
University of the Witwatersrand Faculty of Health Sciences
France, Paris
Lelie Research
Dickens, Caroline
South Africa, Weltevreden Park
South African National Blood Service
South Africa, Johannesburg
University of the Witwatersrand Faculty of Health Sciences
France, Paris
Lelie Research
Lelie, Nico
South Africa, Weltevreden Park
South African National Blood Service
South Africa, Johannesburg
University of the Witwatersrand Faculty of Health Sciences
France, Paris
Lelie Research
Walker, Evangelia
South Africa, Weltevreden Park
South African National Blood Service
South Africa, Johannesburg
University of the Witwatersrand Faculty of Health Sciences
France, Paris
Lelie Research
Coleman, Charl
South Africa, Weltevreden Park
South African National Blood Service
South Africa, Johannesburg
University of the Witwatersrand Faculty of Health Sciences
France, Paris
Lelie Research
Keyter, Mark
South Africa, Weltevreden Park
South African National Blood Service
South Africa, Johannesburg
University of the Witwatersrand Faculty of Health Sciences
France, Paris
Lelie Research
Reddy, Ravi
South Africa, Weltevreden Park
South African National Blood Service
South Africa, Johannesburg
University of the Witwatersrand Faculty of Health Sciences
France, Paris
Lelie Research
Crookes, Robert L.
South Africa, Weltevreden Park
South African National Blood Service
South Africa, Johannesburg
University of the Witwatersrand Faculty of Health Sciences
France, Paris
Lelie Research
Kramvis, Anna
South Africa, Weltevreden Park
South African National Blood Service
South Africa, Johannesburg
University of the Witwatersrand Faculty of Health Sciences
France, Paris
Lelie Research
Statistics
Citations: 80
Authors: 9
Affiliations: 3
Identifiers
Doi:
10.1111/j.1537-2995.2011.03355.x
ISSN:
00411132
e-ISSN:
15372995
Research Areas
Genetics And Genomics
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Locations
South Africa