Detection of HBV DNA by nested-PCR in a HBsAg and anti-HBc negative blood bank donor

Background: The criteria and protocol adopted in serological screening of blood bank donors have significantly reduced the possibility of HBV transmission. However, it is possible that, in a very recent phase of HBV infection, HBsAg seronegative donors be able to transmit the virus. This study reports a case of a donor with this serological profile who was involved in the viral transmission to a seronegative receptor. Case report: A blood donor had her sample tested for HBsAg and anti-HBc, which resulted negative. At the second donation the sample demonstrated to be seropositive for anti-HBc, anti-HBs and seronegative for HBsAg. The first stored sample was tested for the presence of HBV DNA. Two fragments could be identified in the genomic region corresponding to HBV core and precore. Only one individual was involved in the transfusion of hemo-derivatives originating from the processing of this bag, and was seropositive for HBsAg, HBeAg and anti-HBc markers and seronegative for the anti-HBe and anti-HBs markers. Conclusion: This case illustrates the possibility of the occurrence of HBV transmission from blood bank donors seronegative for HBsAg and anti-HBc. This fact could be associated with the possibility of the donor to be in the pre-seroconversion phase of a recent infection, when the levels of HBsAg present in the circulation are below the limits of detection. The implementation of molecular tests or higher sensitivity HBsAg assays could further reduce the risk of HBV transmission via blood transfusion. (c) 2006 Elsevier B.V. All rights reserved.