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. 2024 Feb 3;10(3):e25805.
doi: 10.1016/j.heliyon.2024.e25805. eCollection 2024 Feb 15.

Efficacy of combined HBsAg, anti-HBc and anti-HBs screening in minimizing transfusion transmission risk of hepatitis B infection in low resource setting

Shreyasi Athalye  1 , Amruta Patil  2 , Naveen Khargekar  3 , Shailesh Shinde  1 , Shreya Chavan  1 , Abhay Dixit  4 , Aruna Shankarkumar  1 , Manisha Madkaikar  5 , Anindita Banerjee  1
Affiliations

Efficacy of combined HBsAg, anti-HBc and anti-HBs screening in minimizing transfusion transmission risk of hepatitis B infection in low resource setting

Shreyasi Athalye et al. Heliyon. .

Abstract

Background: Hepatitis B Virus (HBV), and occult Hepatitis B in particular, is a major concern in the transfusion scenario, especially in endemic countries. This study attempted to estimate the prevalence of occult Hepatitis B infection (OBI) among voluntary blood donors in Maharashtra and to evaluate the role of combined screening strategy with implications in minimizing the current transfusion risks of seropositive OBI.

Methods: Donor samples were collected from 80 eligible blood banks from various districts of Maharashtra between 2014 and 2017. ELISA based screening of HBsAg, anti-HBc (total and IgM), anti-HBs titres. Real-time quantitative PCR for Hepatitis B Virus DNA (HBV DNA) were performed for all HBsAg and or anti-HBc positive samples.

Results: Out of 2398 samples tested, 20 (0.83%) samples were positive for HBsAg, whereas 547 (22.81%) were positive for anti-HBc. Out of 547 samples, 16 (2.92%) were positive for HBV DNA with median level at 247.89 IU/mL (IQR: 126.05-666.67 IU/mL). Anti-HBs levels were positive in 35.83% of OBI cases. ROC curve analysis showed that combined HBsAg, anti-HBc and anti-HBs (>50 mIU/mL) screening can more efficiently detect HBV infection in blood donors than HBsAg alone.

Conclusions: A combined HBsAg, anti-HBc and anti-HBs screening for donor samples could be an alternative achievable strategy to minimize the HBV transmission as well as financial burden. In resource limited setup, the proposed combined strategy could be helpful in minimizing the risk of OBI transmission.

Keywords: Blood safety; Hepatitis B virus; OBI transmission; Occult hepatitis B; anti-HBc screening.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Dr Aruna Shankarkumar reports financial support was provided by National Health Mission, Maharashtra. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Screening strategy for serological markers of Hepatitis B.
Fig. 2
Fig. 2
HBV DNA detection in anti-HBc positive samples.
Fig. 3
Fig. 3
Receiver Operating Characteristic of different screening strategies to compare the efficacy of combined screening and HBsAg alone with HBV DNA as gold standard.
Fig. 4
Fig. 4
Estimated number of HBsAg positive and OBI cases per 1000 donors screened.
Fig. 5
Fig. 5
Proposed OBI screening strategy for in lieu of ID-NAT.
See this image and copyright information in PMC

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