Wang, Jin-TownJin-TownWangLee, Cha-ZeCha-ZeLeePEI-JER CHENWang T-.H.DING-SHINN CHEN2021-07-032021-07-0320020041-1132https://www.scopus.com/inward/record.uri?eid=2-s2.0-84983726669&doi=10.1046%2fj.1537-2995.2002.00274.x&partnerID=40&md5=c4e50d54922025109820194370797168https://scholars.lib.ntu.edu.tw/handle/123456789/568786BACKGROUND: By NAT, HBV DNA is occasionally detectable in blood donors with past HBV infection but negative for HBsAg. Whether or not these donors can cause transfusion-transmitted HBV infections is uncertain. STUDY DESIGN AND METHODS: To determine whether or not donors with past HBV infection but negative for HbsAg can cause HBV transfusion-transmitted infections, recipients followed for blood transfusion in a university medical center in Taiwan were studied. HBV DNA and serologic markers were tested in donors and recipients. RESULTS: Of 1,038 enrolled recipients, 910 completed the 6-month post-transfusion follow-up visit. Of these, only 39 patients (4.3%) tested negative on the pretransfusion sample for HBsAg, anti-HBs, anti-HBc, and HBV DNA by PCR. These 39 HBV-naive recipients had been transfused with blood from 147 donations for which stored samples were available for HBV DNA testing by PCR; 11 of these HBsAg-negative samples tested positive for HBV DNA and anti-HBc. Two of the 11 patients who received the HBV-DNA-positive donations (18%) became positive for HBV DNA, and one seroconverted to anti-HBc and finally to anti-HBs, with a mild transient elevation of serum ALT activities. Based on the one confirmed case of HBV transmission, a projection was made that approximately 200 post-transfusion HBV infections could occur in one million units of transfused blood in Taiwan. CONCLUSIONS: In HBV-endemic areas like Taiwan, where blood donors are screened for HBsAg only, the risk of transfusion-transmitted HBV appears to be substantial. Implementation of NAT for blood screening in these settings warrants consideration.[SDGs]SDG3hepatitis B surface antigen; virus antibody; virus antigen; virus DNA; article; blood; blood donor; blood transfusion; disease transmission; DNA sequence; endemic disease; follow up; hepatitis B; Hepatitis B virus; human; immunology; molecular genetics; prospective study; Taiwan; Antibodies, Viral; Antigens, Viral; Blood Donors; Blood Transfusion; DNA, Viral; Endemic Diseases; Follow-Up Studies; Hepatitis B; Hepatitis B Surface Antigens; Hepatitis B virus; Humans; Molecular Sequence Data; Prospective Studies; Sequence Analysis, DNA; Taiwanjournal article10.1046/j.1537-2995.2002.00274.x124731402-s2.0-84983726669