Thématique :
- Foie
Originalité :
Solidité :
Très solide
Doit faire évoluer notre pratique :
Dans certains cas
Nom du veilleur :
Docteur Jean-Louis PAYEN
Coup de coeur :
Journal of Hepatology
  2015 Nov;63(5):1068-76  
  doi: 10.1016/j.jhep.2015.06.016  
  Poor efficacy of nucleic acid testing in identifying occult HBV infection and consequences for safety of blood supply in Italy  
  Spreafico M, Berzuini A, Foglieni B, Candotti D, Raffaele L, Guarnori I, Colli A, Maldini FF, Allain JP, Prati D  


In Italy, DNA screening of blood donations for hepatitis B virus (HBV) was introduced to prevent the transmission of window period and occult HBV infection. Anti-HBc screening is not recommended in order to avoid shortage of the blood supply. To contain costs, donor samples are generally pooled before testing. We evaluated the safety of this national policy using a prospective repository of donors/recipient pairs.


We used highly sensitive nucleic acid testing (NAT) assays to test repository and follow-up samples from donors who were initially classified as negative by minipool NAT assays (6-MP), but were later found to carry occult HBV DNA. When available, we also analysed recipients' pre- and post-transfusion samples, collected in the context of a repository financed by the European Commission (the BOTIA project).


Between 2008 and 2011 6-MP NAT assays identified 18 carriers of occult HBV infection among 12,695 donors; 28 samples from previous donations were available from 13 of these carriers. Highly sensitive HBV DNA detection methods showed that 6-MP HBV DNA screening failed to identify 14/28 (50%) viraemic donations, that were released for transfusion. HBV marker testing of such blood product recipients revealed two cases of transfusion transmitted HBV infection, documented by donor-recipient sequence identity.


Viraemic blood donations from occult HBV infection carriers remain undetected by current minipool HBV DNA screening, and transfusion transmission of HBV continues to occur in susceptible patients. More effective individual HBV DNA screening and/or tests for antibodies to HBV core antigen should be considered to improve blood safety.

Question posée
Stratégie pour détecter les donneurs de sang porteurs du VHB.
Question posée
Voir commentaire.

La stratégie pour détecter les donneurs de sang porteurs du VHB est discutée. Cette étude apporte une pierre dans la réflexion autour de ce questionnement. Nous connaissons ces infections occultes qui, comme le confirme ce travail, peuvent se transmettre par voie transfusionnelle malgré les tests de dépistages actuellement utilisés en France notamment.