Occult hepatitis B virus infection among blood donors – a pilot study
General Medicine, 2025, 27(4), 21-27.
General Medicine, 2025, 27(4), 15-20.
N. Doseva1, D. Lyubomirova2, I. Gencheva3, M. Karamanliev4, I. Ivanov5, M. Karcheva6
1 Department of Physiology and Pathophysiology, Faculty of Medicine, Medical University ‒ Pleven
2 Department of Nephrology, Hematology and Gastroenterology, Faculty of Medicine, Medical University ‒ Pleven
3 Department of Clinical Laboratory, Immunology and Allergology, Faculty of Health Care, Medical University ‒ Pleven
4 Department of Propedeutics of Surgical Diseases, Faculty of Medicine, Medical University ‒ Pleven
5 Department of Pathology, Faculty of Medicine, Medical University ‒ Pleven
6 Department of Infectious Diseases, Epidemiology, Parasitology and Tropical Medicine, Faculty of Public Health, Medical University ‒ Pleven
Abstract. Introduction: Occult hepatitis B virus (HBV) infection represents a serious challenge for transfusion medicine due to the inability to detect HBV surface antigen (HBsAg) during standard serological screening. The application of Nucleic Acid Testing (NAT) (a technique for amplification of nucleic acids) reduces the transfusion risk. Objective: To assess the frequency, epidemiological and clinical-laboratory characteristics of occult hepatitis B virus infection among blood donors in the Regional Center for Transfusion Hematology – Pleven. Materials and Methods: An epidemiological study of blood donors with a negative result for HBsAg and a positive result for HBV deoxyribonucleic acid (DNA) was performed. A questionnaire survey was conducted to collect epidemiological and demographic data on the participants. Serological tests were performed (HBV markers: anti-HBc antibodies, anti-HBs antibodies, HBeAg, anti-HBe antibodies), molecular biological test – polymerase chain reaction for quantitative determination of HBV DNA, physical examination and ultrasound examination of the liver, laboratory tests (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, albumin and total bilirubin). Results: Of the 21 955 blood donors examined in 2024, 14 individuals (0.06%) tested negative for HBsAg and positive for HBV DNA. Five of these blood donors participated in the study. Three of the participants had risk factors for infection and progression of hepatitis B infection. One participant had elevated liver enzymes, possibly related to alcohol damage. Only one of the participants was vaccinated for HBV, but had a low titer for anti-HBs antibodies. Conclusion: Occult hepatitis B virus infection poses a risk not only to recipients of blood and blood components, but also to blood donors themselves. The increased risk of liver complications, including hepatocellular carcinoma, requires not only detection, but also longterm follow-up of blood donors with occult hepatitis B infection.
Key words: occult infection, hepatitis B, blood donors
Address for correspondence: Nely Doseva, MD e-mail: dosesva.nely@gmail.com