Occult hepatitis B virus infection: risk for a blood supply, but how about individuals’ health?
Michael X. Fu, Ahmed M Elsharkawy, Brendan Healy, Celia Jackson, Daniel Bradshaw, Emma Watkins, Ines Ushiro‐Lumb, Jaisi Griffiths, James Neuberger, Kathryn Maguire, Monica Desai, Neil McDougall, Nicole Priddee, Stephen T. Barclay, Stuart Blackmore, Peter Simmonds, William L. Irving, Heli Harvala
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.