Status:
Ready to upload
Record number:
1838
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Transmission of HBV through blood transfusion is rare, but reported.
Time to detection:
The mother of Recipient 1 was the trigger of the investigation by developing acute hepatitis B virus infection identified 16 months after
delivering her last child. The child was transfused 3 weeks after birth with red cell concentrates.
Alerting signals, symptoms, evidence of occurrence:
Infection in the mother of the infant infected by transfusion was confirmed by high level of ALT, high viral load, positive anti-HBc, and declining
HBsAg. This led to discovery of the infant's infection through transfusion. Another recipient of the same RBC unit (another infant) was also infected. A third infant was transfused but not infected, thought due to previous vaccination of the mother and circulation of anti-HBs antibodies.
Demonstration of imputability or root cause:
In order to determine whether the donor was the potential origin of the three infections, full genome sequencing of HBV was performed separately for each sample in order to exclude the risk of laboratory cross-contamination. All three strains were identical. Blood donor screening was done with Hep B surface antigen and did not include HBV NAT.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
Reference attachment:
Suggest references:
Niederhauser C, et al. Reverse vertical transmission of hepatitis B virus (HBV) infection from a transfusion-infected newborn to her mother. J Hepatol. 2012 Mar;56(3):734-7
Note:
Similar topic in Notify record n.1723, linked to a 2014 paper of Khanna et al (EP)
Expert comments for publication:
Elegant study from Switzerland showing transmission of HBV through RBC transfusion in two children and protection against transmission of a newborn through maternal vaccination. "Reverse vertical transmission" from baby to mother is described but did not happen during childbirth nor breast feeding; unclear mechanism of infection from baby to mother, but possibly via infant body fluid contact. Note that donor screening was done with Hep B surface antigen, and HBV NAT was subsequently implemented in Switzerland.