Occult Hepatitis B Virus Infection: A Killer Hidden in Transfused Blood, Sudan

Abstract

Introduction: Transmission of hepatitis B virus (HBV) through the blood is a significant risk, especially in poor countries with high endemicity. Occult transmission of HBV (OBI) is an important acquisition scenario. Objective: A cross-sectional laboratory-based study followed to detect OBI in blood of accepted donors admitted to Mad Medani Blood Bank, Sudan. Methods: During the study, 200 accepted blood units were examined for HBsAg by ELISA technique and negative samples were tested for total anti-HBc antibodies using electroluminescence immunoassay (ECLIAS). HBV DNA amplification was performed for units that showed total anti-Hbc positivity. Results: Of the 200 blood units, 3 appeared positive by ELISA. Total anti-HBc antibodies were present in 34% (67/197) of blood units. HBV DNA was successfully amplified in 52.2% (35/67) of total anti-HBc positive samples. A significant association was observed between reactive total anti-HBc and age group (p < 0.001), marital status (p < 0.001) and HBV vaccination (p-value 0.012) of blood donors. Conclusion: OBI was recorded at a high rate in the blood of donors, which necessitates the implementation of detection methods to protect the recipients.