Occult hepatitis B virus infection as a cause of posttransfusion hepatitis in patients with cancers |
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Authors: | Jaswinder Singh Sodhi Nayeem Wani Samoon Jeelani Sajad Geelani Fehmida Akhtar Gul Javid Gh Nabi Yattoo Altaf Shah Gh Mohd Gulzar Mushtaq A. Khan Shaheena Parveen Riyaz-u Saif Abid Showkat |
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Affiliation: | 1. Department of Gastroenterology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir, 190 011, India 3. Department of Blood Transfusion and Immunohematology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir, 190 011, India 2. Department of Clinical Hematology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir, 190 011, India
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Abstract: | Background Prevalence of hepatitis B virus (HBV) infection is increased in patients of cancer with increased mortality. Multiple transfusions of blood and blood-related products are a potential source. Aims This study aims to assess the incidence of hepatitis B surface antigen (HBsAg) seroconversion in cancer patients receiving transfusion of blood or blood-related products and identify possible reasons for infection in these patients. Material and Methods Patients of cancer receiving blood products, who were HBsAg-, anti-hepatitis B core (HBc)-, and HBV DNA-negative prior to transfusion, were tested for HBsAg by ELISA at 6, 12, and 24 weeks after the last transfusion. Blood donors were screened for HBsAg by ELISA. Results Twenty of 3,600 (0.56 %) blood donors tested positive for HBsAg and were rejected. Nine of 150 (6 %) cancer patients became HBsAg-positive posttransfusion which included seven patients who presented with acute hepatitis B and other two patients who remained HBsAg-positive without hepatitis. In 6/9 (66.6 %) patients, HBsAg positivity was related to blood transfusion as their corresponding blood donors on retesting the stored samples were positive for anti-HBc antibody and HBV DNA. In other three patients, the cause of their HBsAg positivity could not be ascertained. Conclusion Occult HBV infection in blood donors is a potential source of posttransfusion HBV infection in recipients. Anti-HBc antibody and HBV DNA should be tested in blood donors especially when blood is given to cancer patients receiving chemotherapy. |
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