Journal of Hepatology
Volume 49, Issue 4 , Pages 537-547, October 2008

Characterization of occult hepatitis B virus from blood donors carrying genotype A2 or genotype D strains☆

  • Daniel Candotti

      Affiliations

    • National Health Service Blood and Transplant, Cambridge Blood Centre, Cambridge, United Kingdom
    • ,
  • Piotr Grabarczyk

      Affiliations

    • Institute of Haematology and Transfusion Medicine, Warsaw, Poland
    • ,
  • Paola Ghiazza

      Affiliations

    • Struttura di Qualificazione Biologica del Sangue, Ospedale Sant’ Anna, Torino, Italy
    • ,
  • Roberto Roig

      Affiliations

    • Centro Transfusion Comunidad Valencia, Valencia, Spain
    • ,
  • Natalia Casamitjana

      Affiliations

    • Centre de Transfusió i Banc de Teixits, Barcelona, Spain
    • ,
  • Paola Iudicone

      Affiliations

    • Azienda Ospedaleria S Camillo-Forlanini, Rome, Italy
    • ,
  • Michael Schmidt

      Affiliations

    • Institute of Transfusion Medicine and Immunohematology, Johann Wolfgang Goethe University, Frankfurt, Germany
    • ,
  • Arthur Bird

      Affiliations

    • Western Province Blood Transfusion Service, Cape Town, South Africa
    • ,
  • Robert Crookes

      Affiliations

    • South African National Blood Service, Johannesburg, South Africa
    • ,
  • Ewa Brojer

      Affiliations

    • Institute of Haematology and Transfusion Medicine, Warsaw, Poland
    • ,
  • Michelina Miceli

      Affiliations

    • Azienda Ospedaleria S Camillo-Forlanini, Rome, Italy
    • ,
  • Azin Amiri

      Affiliations

    • Department of Haematology, University of Cambridge, Cambridge Blood Centre, Long Road, Cambridge CB2 2PT, United Kingdom
    • ,
  • Chengyao Li

      Affiliations

    • National Health Service Blood and Transplant, Cambridge Blood Centre, Cambridge, United Kingdom
    • Southern Medical University, Guangzhou, China
    • ,
  • Jean-Pierre Allain

      Affiliations

    • Department of Haematology, University of Cambridge, Cambridge Blood Centre, Long Road, Cambridge CB2 2PT, United Kingdom
    • Corresponding Author InformationCorresponding author. Tel.: +44 1223 548044; fax: +44 1223 548155.

Received 6 February 2008; received in revised form 8 April 2008; accepted 19 April 2008. published online 29 May 2008.

Associate Editor: F. Zoulim

Background/Aims

Nucleic acid testing (NAT) for hepatitis B virus (HBV) DNA in blood donations identified occult HBV infection (OBI) as a potential threat to blood safety.

Methods

A collaborative study was undertaken to explore the molecular basis of OBIs prevalent in Europe in relation to clinical and serological data.

Results

Ninety-one percent of 77 donor samples of European origin HBV DNA positive but HBV surface antigen (HBsAg) negative were confirmed. Viral load ranged between unquantifiable and 5640IU/mL (median 25IU/mL). Fifty-two strains were genotyped (14 HBVA2 and 38 HBVD). Compared to HBsAg+ samples, genotype D was significantly more frequent than genotype A2 in OBIs from Poland or Italy (P<0.04). Amino acid substitutions were concentrated in the immunologically active parts of the Pre-S/S proteins (P<0.0001) affecting both cellular CD8 T-cell epitopes and B-cell neutralizing Major Hydrophilic Region epitopes. Substitutions were more frequent in OBIs than in HBsAg+ strains of both genotype D (P<0.001) and A2 (P<0.01), in OBIs of genotype D than A2 in the ‘a’ region (P<0.001) but not cellular epitopes, and in anti-HBs+ than anti-HBs− OBIs (P<0.001).

Conclusions

Results support the hypothesis that humoral and cellular immune pressure on the HBV envelope proteins are major mechanisms generating OBI.

Keywords: Occult HBV, HBV, Blood donors, Europe

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☆ None of the co-authors has any conflict of interest to declare concerning the material presented in this manuscript. Dr. Allain is an occasional lecturer for the Chiron/Novartis Corporation.

PII: S0168-8278(08)00346-2

doi:10.1016/j.jhep.2008.04.017

Journal of Hepatology
Volume 49, Issue 4 , Pages 537-547, October 2008

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