Screens for serologic markers of Hepatitis B virus are used to prevent its transmission through transplantation.
However, exclusion of noninfectious seropositive donors exacerbates graft shortages, and a residual risk of transmission by seronegative donors also exists.
Dr Dominique Challine and colleagues from France assessed the risk of Hepatitis B virus associated with different Hepatitis B virus serologic profiles in organ, tissue, and cell transplants.
The research team also examined the risk of Hepatitis B virus transmission from seronegative donors.
The team screened a total of 11,155 consecutive organ, tissue, and cell donors for Hepatitis B virus serologic markers.
|Prevalence of Hep B in organ donors with no serologic markers was less than 1%|
Hepatitis B virus DNA was screened for in 626 donors with at least 1 Hepatitis B virus serologic marker.
A further 1433 multiple organ donors were screened who were Hepatitis B virus seronegative or had anti-hepatitis B surface antigens antibodies alone.
The researchers found that the Hepatitis B virus DNA was detected in most anti-hepatitis B surface antigens anti-hepatitis B surface antigens-antigen–positive donors.
However, Hepatitis B virus-DNA levels were considerably lower than in patients with chronic Hepatitis B.
The team found Hepatitis B virus DNA in organ and cornea donors without anti-hepatitis B surface antigens antigen.
The researchers noted that the prevalence of Hepatitis B virus DNA in organ donors with no Hepatitis B virus serologic markers or isolated anti-antibodies was less than 1%.
One Hepatitis B virus-DNA–positive organ donor with isolated anti-anti-hepatitis B surface antigens antibodies had amino acid substitutions in the Hepatitis B surface antigen sequence.
Dr Challine’s team concluded, “The analytic sensitivity of commercial Hepatitis B surface antigen assays and their ability to detect anti-hepatitis B surface antigens mutants should be improved.”
“The utility and cost-efficacy ratio of systematic Hepatitis B virus-DNA testing should be assessed with the goal of excluding Hepatitis B virus-DNA–positive donations not identified through serologic testing, while retaining donations that carry no risk of Hepatitis B virus transmission.”