Occult hepatitis B virus infection: risk for a blood supply, but how about individuals' health?
Fu, Michael X Elsharkawy, Ahmed Healy, Brendan Jackson, Celia Bradshaw, Daniel Watkins, Emma Ushiro-Lumb, Ines Griffiths, Jaisi Neuberger, James Maguire, Kathryn
Fu, Michael X
Elsharkawy, Ahmed
Healy, Brendan
Jackson, Celia
Bradshaw, Daniel
Watkins, Emma
Ushiro-Lumb, Ines
Griffiths, Jaisi
Neuberger, James
Maguire, Kathryn
Affiliation
University of Oxford; University Hospitals Birmingham NHS Foundation Trust; Public Health Wales; Swansea Bay University Health Board; West of Scotland Specialist Virology Centre; UK Health Security Agency; NHS Blood and Transplant; Wales Specialist Virology Centre; Northern Ireland Blood Transfusion Service; Belfast Health and Social Care Trust; Scottish National Blood Transfusion Service; NHS Greater Glasgow and Clyde; Welsh Blood Service; Nottingham University Hospitals NHS Trust; University of Nottingham
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Publication date
2025-02-01
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Abstract
The implementation of effective blood donation screening for hepatitis B virus (HBV) anti-core antibodies with highly sensitive molecular HBV DNA detection in low-endemic countries like the United Kingdom has improved blood safety. However, the linkage to care and management for blood donors with occult HBV infection (OBI) is a complex dilemma involving virological, clinical, methodological, and social issues. Limited evidence suggests that OBI may accelerate the progression of liver disease and cancer. The need for a specialist referral for donors identified with OBI carries mixed opinions from blood establishments, hepatologists, and public health. Following extensive multidisciplinary discussions, experts agree upon a need for clear messaging for donors and to consider the oncogenic implications of OBI. Proposals for future studies are identified, and the applicability of the recommendations in low-resource, high-endemic regions is considered, as well as the inclusion of OBI in global hepatitis elimination targets.
Citation
Fu MX, Elsharkawy A, Healy B, Jackson C, Bradshaw D, Watkins E, Ushiro-Lumb I, Griffiths J, Neuberger J, Maguire K, Desai M, McDougall N, Priddee N, Barclay ST, Blackmore S, Simmonds P, Irving WL, Harvala H. Occult hepatitis B virus infection: risk for a blood supply, but how about individuals' health? EClinicalMedicine. 2025 Feb 1;81:103095. doi: 10.1016/j.eclinm.2025.103095.
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Article