Occult hepatitis B infection among blood donors from Yaoundé, Cameroon

Diderot Fopa; Daniel Candotti; Claude T Tagny; Camille Doux; Dora Mbanya; Edward L Murphy; Hany I Kenawy; Farha El Chenawi; Syria Laperche

doi:10.2450/2019.0182-19

Occult hepatitis B infection among blood donors from Yaoundé, Cameroon

Blood Transfus. 2019 Nov;17(6):403-408. doi: 10.2450/2019.0182-19.

Authors

Diderot Fopa¹, Daniel Candotti², Claude T Tagny^{1

3}, Camille Doux², Dora Mbanya^{1

3}, Edward L Murphy⁴, Hany I Kenawy⁵, Farha El Chenawi⁶, Syria Laperche²

Affiliations

¹ Haematology and Transfusion Service, University Teaching Hospital, Yaoundé, Cameroon.
² National Institute of Blood Transfusion/INTS, Department of Blood Borne Agents, National Reference Center for Infectious Risks in Blood Transfusion, Paris, France.
³ Department of Haematology, Faculty of Medicine and Biomedical Sciences of University of Yaoundé I, Yaoundé, Cameroon.
⁴ University of California San Francisco and Vitalant Research Institute, San Francisco, CA, United States of America.
⁵ Faculty of Pharmacy, Mansoura University, Mansoura, Egypt.
⁶ Faculty of Medicine, Mansoura University, Mansoura, Egypt.

Abstract

Background: In Cameroon, the prevention of hepatitis B virus (HBV) transmission by blood transfusion is still only based on hepatitis B surface antigen (HBsAg) screening. However, occult HBV infection (OBI) characterised by the absence of detectable HBsAg and low level of viral DNA remains a potential threat for blood safety. The prevalence of OBI was investigated in blood donors from Yaoundé to provide evidence-based recommendations to improve HBV blood safety.

Material and methods: Blood donations from August 1^st, 2016 to March 31^st, 2017 were routinely screened for HBV, human immunodeficiency virus (HIV), and hepatitis C virus (HCV) infections (Murex HBsAg Version 3, Murex HIV Ag/Ab Combination, and Murex HCV Ag/Ab Combination [DiaSorin]). Additional HBV investigations were performed, including hepatitis B core antibody ([HBc] Monolisa Anti-HBc PLUS; BIO-RAD) and HBV DNA tested in minipools of two samples using the quantitative Cobas Taqman HBV assay (Roche; LoQ: 6 IU/mL) and HBV DNA genotyping by sequencing.

Results: Of 1,162 donations analysed, 91 (7.8%) were reactive for HBsAg. All of them were also anti-HBc positive. Among the 1,071 HBsAg negative samples, 522 (48.7%) were reactive for anti-HBc. Six (0.56% of all donations) samples fulfilled the consensus definition of OBI and showed low HBV DNA loads (all <6 IU/mL). Following nested polymerase chain reaction amplifications, HBV DNA sequences were obtained for 4 of these samples (1 nearly whole genome [3123 nt], 2 Pre-S/S regions [1,356 nt], and 1 S region [445 nt]). Phylogenetic analysis identified genotype E in all samples.

Discussion: Around 1 in 100 Cameroonian blood donors screened who resulted HBsAg negative and anti-HBc positive carried occult HBV infection. HBsAg alone for screening prospective donors is not sufficient to eliminate the risk of HBV transfusion transmission in Cameroon, and because anti-HBc screening does not seem to be feasible without compromising blood supply, implementation of HBV nucleic acid testing could be considered when possible.

Publication types

Clinical Trial
Multicenter Study

MeSH terms

Adult
Blood Donors*
Blood Safety*
Cameroon / epidemiology
DNA, Viral / blood*
Donor Selection*
Female
Hepatitis B / blood*
Hepatitis B / epidemiology
Hepatitis B Surface Antigens / blood*
Hepatitis B virus*
Hepatitis C / blood
Hepatitis C / epidemiology
Humans
Male
Polymerase Chain Reaction

Substances

DNA, Viral
Hepatitis B Surface Antigens

Abstract

Publication types

MeSH terms

Substances

Grants and funding