ArticleBlood transfusion = Trasfusione del sangue2022
Alternative hepatitis B virus DNA confirmatory algorithm identified occult hepatitis B virus infection in Chinese blood donors with non-discriminatory nucleic acid testing.
Article in Blood transfusion = Trasfusione del sangue, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 12 citations in OpenAlex.
- Hepatitis B virus infection with high HBsAg and undetectable DNA levels in untreated blood donors: Viral mechanisms and transfusion safety implications.Transfusion · 2026Article
- Comparison of nucleic acid testing and enzyme-linked immunosorbent assay in screening Hepatitis-B Virus in blood samples.Pakistan journal of medical sciences · 2026Article
- Advances in Novel Detection Technologies for Occult Hepatitis B Virus Infection: Building an Ultra-Sensitive Barrier for Transfusion Safety.Microorganisms · 2025Review
- Comprehensive evaluation of NAT+/HBsAg- blood donors: confirmation strategies, serial testing outcomes, and S gene mutations associated with occult HBV infection.BMC infectious diseases · 2025Article
- Hepatitis B and C landscape in Uzbekistan: epidemiological patterns revealed in a study of 1 040 000 people.European journal of public health · 2025Article
- Transfusion-transmitted occult hepatitis B virus infection: current understanding, challenges, and its implication in blood safety.Frontiers in immunology · 2025Review
- Cost-benefit analysis of serological and nucleic acid testing for hepatitis B virus in blood donors in southern China.BMC infectious diseases · 2024Article
- Establishing a screening strategy for non-discriminatory reactive blood donors by constructing a predictive model of hepatitis B virus infection status from a single blood center in China.Frontiers in public health · 2024Article
- Article
- Re-Entry Evaluation of Chinese Blood Donors with Unconfirmed Hepatitis B Screening Results.Viruses · 2022Review
- Anti-HBc-nonreactive occult hepatitis B infections with HBV genotypes B and C in vaccinated immunocompetent adults.Journal of viral hepatitis · 2022Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMultiplex viral nucleic acid testing (NAT) and a discriminatory testing algorithm have been used to detect viral infections in blood donors. Non-discriminated reactive (NDR) results may arise from low hepatitis B virus (HBV) DNA levels and are challenging for donor management by blood services. The aim of this study was to evaluate the performance and feasibility of alternative viral particle concentration methods to confirm and to characterise HBV infection status in NDR donors from Dalian, China, in order to improve routine donor management according to the potential residual risk estimate. MATERIALS AND
methodsIndividual donations were tested with ULTRIO Plus, and discriminated when reactive. Virions were concentrated from 12 and 6 mL plasma samples by ultracentrifugation (UC) and polyethylene glycol (PEG) precipitation, respectively. HBV DNA was detected with four nested polymerase chain reactions (95% limit of detection: 5-25 IU/mL). Amplified products were sequenced for definitive confirmation. Anti-HBc and anti-HBs were tested.
resultsOf 77,556 donors, 79 (0.1%) were NAT NDR. After viral particle concentration by UC and PEG precipitation, HBV DNA was detected in 46 (58.2%) and 34 (43.0%) NDR donors, respectively, including 61.7% of samples that were repeatedly non-reactive with multiple NAT testing. Anti-HBc and anti-HBs (median titre: 37 mIU/mL) were detected in 87.3% and 46.8% of NDR donors, respectively. Sequencing confirmed HBV DNA in 65.8% of NDR donors, of whom 96.2% were occult HBV carriers with rare mutations in S and core proteins. DISCUSSION: A HBV DNA confirmatory procedure with limited technical constraints was implemented successfully. The majority of NDR donors had occult HBV infections with extremely low viral DNA levels, which may constitute a potential residual threat for blood safety. Only a minority of anti-HBc+ NDR donors had anti-HBs levels high enough to consider their reinstatement as donors. The data support the permanent deferral of NDR donors to ensure maximum blood safety in areas of high HBV endemicity.
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