Molecular characterization of occult hepatitis B cases in Greek blood donors |
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| Authors: | Antigoni Katsoulidou Dimitrios Paraskevis Emmanouil Magiorkinis Zissis Moschidis Catherine Haida Eleni Hatzitheodorou Agoritsa Varaklioti Anastasia Karafoulidou Maria Hatzitaki Lilian Kavallierou Athanasia Mouzaki Evaggelia Andrioti Chrysanthi Veneti Athanasia Kaperoni Eleftheria Zervou Constantina Politis Angelos Hatzakis |
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| Affiliation: | 1. Department of Hygiene and Epidemiology, Athens University Medical School, Athens, Greece;2. 2nd Regional Blood Transfusion Center, “Laiko” General Hospital, Athens, Greece;3. Blood Donation Center of Thessaly, Larisa, Greece;4. “A. Fleming” Blood Transfusion Center, Athens, Greece;5. Division of Hematology, Department of Internal Medicine, Medical School University of Patras, Patras, Greece;6. “Ippokration” General Hospital, Athens, Greece;7. “Konstantopoulio” General Hospital N. Ionia, Athens, Greece;8. “Elpis” General Hospital, Athens, Greece;9. Blood Bank, University Hospital, Ioannina, Greece;10. 3rd Regional Blood Transfusion Center, General Athens Hospital “G. Gennimatas,” Athens, Greece;11. Chief of National Retrovirus Reference Center. |
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| Abstract: | The use of sensitive nucleic acid testing for hepatitis B virus in blood donors revealed a number of HBV DNA(+) cases among HBsAg(?) donors, a status known as occult HBV infection. The purpose of this study was the serological and molecular characterization of occult HBV infection in Greek blood donors. A prospective study was undertaken in order to identify occult HBV infection cases in blood donors. As part of the routine screening of blood donations in Greece, blood units were screened individually by a multiplex HIV‐1/HCV/HBV nucleic acid assay. Initially reactive samples were retested with discriminatory assays. HBV DNA(+)/HBsAg(?) samples were tested further for HBV serological markers and HBV DNA was quantified by real‐time PCR. Molecular characterization was performed by sequencing the envelope and polymerase genes of HBV. Preliminary screening revealed 21 occult cases with the following patterns: anti‐HBc only: 7 donors, anti‐HBc/anti‐HBs: 7 donors, anti‐HBc/anti‐HBe: 5 donors, anti‐HBc/anti‐HBs/anti‐HBe: 2 donors. In all cases, the HBV DNA load was <351 IU/ml. Sequencing was successful in 10 donors (classified within genotype D) revealing several amino acid substitutions related to diagnostic escape and antiviral resistance. HBsAg diagnostic failure and low viral replication in occult HBV infection carriers could possibly be attributed to multiple changes in envelope and polymerase regions, respectively. J. Med. Virol. 81:815–825, 2009. © 2009 Wiley‐Liss, Inc. |
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| Keywords: | blood donors nucleic acid testing real‐time PCR sequence analysis phylogeny α ‐determinant |
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