A method for estimating the residual risk of transfusion-transmitted HBV infection associated with occult hepatitis B virus infection in a donor population without universal anti-HBc screening.

Abstract:

BACKGROUND AND OBJECTIVES:This report describes a method for estimating the risk of transfusion-transmitted HBV infection attributable to blood components from donors with occult hepatitis B virus infection (OBI) applicable where universal anti-HBc screening is not performed. MATERIALS AND METHODS:In the context of parallel HBsAg and individual donation HBV DNA testing, we developed a mathematical function p(OBI) to estimate the probability of failing to detect [p(NAT nondetection)] a potentially infectious [p(transmission)] donation from a donor with OBI. RESULTS:Among 1 312 451 donations tested for HBsAg and HBV DNA, 29 (from 17 anti-HBc reactive donors classified as OBI) were individual donation NAT negative, giving a p(NAT nondetection) of 2·2096 (95 CI: 1·538-3·173) × 10(-5) . To date, lookback on OBI donors has identified 35 (8·2%) recipients with evidence of current or past HBV infection among 427 tested recipients. After correcting for the background anti-HBc rate in recipients, this results in a p(transmission) of 0·0384 (0·0167-0·0601). The product, pOBI is 1 in 981 920 (95% CI: 437 181-3 223 701). When this is summed with the WP risk for the 2011-2012 period, the overall HBV residual risk estimate is 1 in 538 224 (95% CI: 209 732-1 552 443). CONCLUSION:We estimate the OBI residual risk in Australia is approximately 1 in 982 000 per unit transfused, and this risk represents 55% of the total HBV residual risk and is declining as consequence of ID-NAT identifying repeat donors with OBI.

journal_name

Vox Sang

journal_title

Vox sanguinis

authors

Seed CR,Kiely P

doi

10.1111/vox.12060

subject

Has Abstract

pub_date

2013-11-01 00:00:00

pages

290-8

issue

4

eissn

0042-9007

issn

1423-0410

journal_volume

105

pub_type

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