Uncovering occult hepatitis B in blood donations: a tale of two worlds

Abstract

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For almost fifty years, improvements in donor selection and screening have led to a continuous reduction in the risk of transfusion-transmitted hepatitis B virus (HBV). However, transmission can still occur when blood is collected from hepatitis B surface antigen (HBsAg) negative donors during the pre-seroconversion window period. Another source of transmission is represented by donors with occult HBV infection (OBI), a condition characterised by persistent HBV carriage in the absence of detectable HBsAg. In many countries, this prompted the introduction of nucleic acid testing (NAT) for HBV and/or antibodies to hepatitis B core (anti-HBc) testing in order to improve detection of infectious donations. [ ... ]