Transfusion medicine
Transfusion transmitted disease
Hepatitis B and transfusion

Author: Huy Phu Pham, M.D. (see Authors page)

Revised: 31 October 2017, last major update October 2011

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Hepatitis B transfusion [title] "loattrfree full text"[sb] treatment

Table of Contents
Definition / general
Cite this page: Pham, H.P. Hepatitis B. PathologyOutlines.com website. http://pathologyoutlines.com/topic/transfusionmedhepatitisB.html. Accessed November 18th, 2017.
Definition / general
  • Hepatitis B is a DNA virus, which is transmitted parenterally, sexually, perinatally
  • Vaccination of infants and high risk adults led to a decrease in U.S. incidence from 260,000 to 60,000 new infections/year
  • Vaccinated children may be susceptible in endemic areas (J Hepatol 2006;44:39)
  • Hepatitis B infection can result in acute infection with subsequent clearance of virus and immunity OR chronic infection with persistent viremia
  • Previously, hepatitis B transmission was most serious transfusion transmitted disease risk but due to serologic testing, risk of transfusion transmitted HBV is now 1:205,000 among repeat donors and 1:144,000 among all donors in the U.S., 1 per 1.3 million units in Australia (Intern Med J 2005;35:592), 1 per 640,000 in France (Transfus Clin Biol 2005;12:239), 1 per 150,000 in Canada (Transfusion 2007;47:316), 1 per 17,500 in Shenzhen, China (Transfusion 2007;47:529), 1 per 1,500 in Mexico (Rev Invest Clin 2006;58:101)
  • Transfusion transmitted hepatitis B may be over reported or under reported
  • To reduce rates even further, vigilance for errors and donor selection may be as important as further testing (Euro Surveill 2005;10:17)
  • Value of nucleic acid testing (NAT) is controversial (helpful in high prevalence area - Vox Sang 2006;91:1, Transfusion 2005;45:1247; not helpful in low endemic areas, Mol Diagn Ther 2006;10:77)
  • In U.S., minipool NAT testing does not decrease the window period significantly
  • In U.S., blood banks use sensitive HBsAg and anti-HBc tests
  • In most of the world, prevalence of anti-HBc is > 10% and use of HBc antibody test may exclude many otherwise healthy donors (J Clin Virol 2006;36:S33)
  • Pathogen inactivation has eliminated transmission in U.S. licensed plasma derivatives since 1985; however cannot be used for cellular components (Arch Pathol Lab Med 2007;131:719)
  • Only one confirmed transfusion related case in U.S. in 2003; false positive seroconversions may occur due to administration of immunoglobulin (Dtsch Med Wochenschr 2006;131:1325)
  • Microarray multiplex assay may be useful to detect Hepatitis B, C and HIV (Biochem Biophys Res Commun 2007;356:1017)