Adverse Occurrence type:
MPHO Type:
Estimates Frequency:
Cannot be determined. Although this lookback study does report the clinical coutcome of the RBC recipient, it does not provide any information about the outcomes of the recipients of other blood components of the same blood donation, if any, such as platelets and plasma. Thus we cannot estimate the efficiency of the RBC and other components to carry and transmit HBV..
Time to detection:
Cannot be determined. This lookback study did not report any clinical signs or symptoms of recipients. HBV infections were asymptomatic. There was insufficient recipient testing to demonstrate when seroconversion first appeared after transfusion.
Alerting signals, symptoms, evidence of occurrence :
This study did not report any signs or symptoms of the HBV infections that developed in two recipients of RBC transfusions. After two regular donors tested positive for HBsAg or anti-HBc, archived seronegative samples from previous donations were tested for HBV DNA and low concentrations were found. The RBCs from these two previous seronegative donations had been transfused into two recipients and HBV. Testing of these recipients was positive for HBV infection. Infection in one recipient resolved spontaneously and in the other resolved after anti-viral therapy.
Molecular analysis including sequencing of the HBV genome and phylogenetic analysis of HBV isolates from the two donors and two RBC recipients showed each donor and recipient in the same cluster with 100% nucleotide homology for genotypes A2 and B4 respectively.
Demonstration of imputability or root cause:
Transfusion transmitted HBV infection was proven by demonstrating HBV in both donor and it recipient. In addition, molecular analysis including sequencing of the HBV genome and phylogenetic analysis of HBV isolates from the two donors and two RBC recipients showed each donor and recipient in the same cluster with 100% nucleotide homology for genotypes A2 and B4 respectively.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Note:
I will try search for similar studies in the Library. If found I will suggest deleting this study.
Suggest new keywords:
HBV, hepatitis B virus infection. HBV DNA, HBsAg, anti-HBc, donor infection, transfusion, red blod cells, lookback,
Adverse occurrence description:
Transfusion-transmitted Hepatitis B Viral infection
Expert comments for publication:
This study of blood donations prior to the institution of routine HBV DNA testing of donors, demonstrated that HBsAg and anti-HBc negative donations can contain HBV DNA and can transmit asymptomatic HBV infections.
Although one of the two recipient infections resolved spontaneously the lookback study brought value to notifying the other recipient with a persistent infection. Because of the lookback study, this recipient infection was identified, antiviral therapy was started and the infection resolved.