Occult hepatitis B virus infection in Thai blood donors

Authors

  • Suda Louisirirotchanakul,

    1. From the Departments of Microbiology and Transfusion Medicine, Faculty of Medicine, Siriraj Hospital, Bangkok; the National Blood Center, The Thai Red Cross Society, Bangkok; the Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Bangkok; the Department of Medical Sciences, Ministry of Public Health, Nonthaburi; and the Department of Microbiology, Faculty of Medicine, Chulalongkorn Hospital, Bangkok, Thailand.
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  • Sineenart Oota,

    1. From the Departments of Microbiology and Transfusion Medicine, Faculty of Medicine, Siriraj Hospital, Bangkok; the National Blood Center, The Thai Red Cross Society, Bangkok; the Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Bangkok; the Department of Medical Sciences, Ministry of Public Health, Nonthaburi; and the Department of Microbiology, Faculty of Medicine, Chulalongkorn Hospital, Bangkok, Thailand.
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  • Kalayanee Khuponsarb,

    1. From the Departments of Microbiology and Transfusion Medicine, Faculty of Medicine, Siriraj Hospital, Bangkok; the National Blood Center, The Thai Red Cross Society, Bangkok; the Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Bangkok; the Department of Medical Sciences, Ministry of Public Health, Nonthaburi; and the Department of Microbiology, Faculty of Medicine, Chulalongkorn Hospital, Bangkok, Thailand.
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  • Wilai Chalermchan,

    1. From the Departments of Microbiology and Transfusion Medicine, Faculty of Medicine, Siriraj Hospital, Bangkok; the National Blood Center, The Thai Red Cross Society, Bangkok; the Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Bangkok; the Department of Medical Sciences, Ministry of Public Health, Nonthaburi; and the Department of Microbiology, Faculty of Medicine, Chulalongkorn Hospital, Bangkok, Thailand.
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  • Soisaang Phikulsod,

    1. From the Departments of Microbiology and Transfusion Medicine, Faculty of Medicine, Siriraj Hospital, Bangkok; the National Blood Center, The Thai Red Cross Society, Bangkok; the Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Bangkok; the Department of Medical Sciences, Ministry of Public Health, Nonthaburi; and the Department of Microbiology, Faculty of Medicine, Chulalongkorn Hospital, Bangkok, Thailand.
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  • Viroje Chongkolwatana,

    1. From the Departments of Microbiology and Transfusion Medicine, Faculty of Medicine, Siriraj Hospital, Bangkok; the National Blood Center, The Thai Red Cross Society, Bangkok; the Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Bangkok; the Department of Medical Sciences, Ministry of Public Health, Nonthaburi; and the Department of Microbiology, Faculty of Medicine, Chulalongkorn Hospital, Bangkok, Thailand.
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  • Tasanee Sakuldamrongpanish,

    1. From the Departments of Microbiology and Transfusion Medicine, Faculty of Medicine, Siriraj Hospital, Bangkok; the National Blood Center, The Thai Red Cross Society, Bangkok; the Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Bangkok; the Department of Medical Sciences, Ministry of Public Health, Nonthaburi; and the Department of Microbiology, Faculty of Medicine, Chulalongkorn Hospital, Bangkok, Thailand.
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  • Pimpun Kitpoka,

    1. From the Departments of Microbiology and Transfusion Medicine, Faculty of Medicine, Siriraj Hospital, Bangkok; the National Blood Center, The Thai Red Cross Society, Bangkok; the Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Bangkok; the Department of Medical Sciences, Ministry of Public Health, Nonthaburi; and the Department of Microbiology, Faculty of Medicine, Chulalongkorn Hospital, Bangkok, Thailand.
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  • Pimol Chielsilp,

    1. From the Departments of Microbiology and Transfusion Medicine, Faculty of Medicine, Siriraj Hospital, Bangkok; the National Blood Center, The Thai Red Cross Society, Bangkok; the Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Bangkok; the Department of Medical Sciences, Ministry of Public Health, Nonthaburi; and the Department of Microbiology, Faculty of Medicine, Chulalongkorn Hospital, Bangkok, Thailand.
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  • Srivilai Tanprasert,

    1. From the Departments of Microbiology and Transfusion Medicine, Faculty of Medicine, Siriraj Hospital, Bangkok; the National Blood Center, The Thai Red Cross Society, Bangkok; the Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Bangkok; the Department of Medical Sciences, Ministry of Public Health, Nonthaburi; and the Department of Microbiology, Faculty of Medicine, Chulalongkorn Hospital, Bangkok, Thailand.
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  • Thaweesak Tirawatnapong,

    1. From the Departments of Microbiology and Transfusion Medicine, Faculty of Medicine, Siriraj Hospital, Bangkok; the National Blood Center, The Thai Red Cross Society, Bangkok; the Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Bangkok; the Department of Medical Sciences, Ministry of Public Health, Nonthaburi; and the Department of Microbiology, Faculty of Medicine, Chulalongkorn Hospital, Bangkok, Thailand.
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  • Chantapong Wasi,

    1. From the Departments of Microbiology and Transfusion Medicine, Faculty of Medicine, Siriraj Hospital, Bangkok; the National Blood Center, The Thai Red Cross Society, Bangkok; the Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Bangkok; the Department of Medical Sciences, Ministry of Public Health, Nonthaburi; and the Department of Microbiology, Faculty of Medicine, Chulalongkorn Hospital, Bangkok, Thailand.
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  • the Working Group for NAT Study in Thai Blood Donations


Suda Louisirirotchanakul, Department of Microbiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand; e-mail: sudaloui@yahoo.com.

Abstract

BACKGROUND: An evaluation by the National Blood Center, the Thai Red Cross Society, of two commercial multiplex nucleic acid tests (NATs; the Chiron PROCLEIX ULTRIO test and the Roche Cobas TaqScreen MPX test) for screening Thai blood donors for hepatitis B virus (HBV), hepatitis C virus, and human immunodeficiency virus Type 1 identified 175 HBV NAT–reactive/hepatitis B surface antigen (HBsAg)-negative donors. The classification of the HBV infection of these donors was confirmed by follow-up testing.

STUDY DESIGN AND METHODS: Index samples were tested for HBV serologic markers and HBV viral loads were determined. Donors were followed for up to 13 months and samples were tested with both NAT assays and for all HBV serological markers.

RESULTS: Of 175 HBV NAT–yield donors, 72 (41%) were followed. Based on the follow-up results, the majority of donors who were followed had an occult HBV infection (66.7%), followed by donors with a primary, acute infection (26.4%). The majority of donors in this latter group (20.8%) were in the window period. Three donors (4.2%), who were anti-HBs positive, had a reinfection or breakthrough infection.

CONCLUSION: The majority of donors detected during routine screening, who were HBsAg negative and NAT reactive, had an occult HBV infection, thus validating the decision to introduce NAT for blood donations in Thailand.

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