Abstract
We experienced a 61-year-old male patient with acute leukemia who was diagnosed with hepatitis B virus (HBV) infection after blood transfusion. At 3 months after transfusion, a blood sample from the same donor was positive for HBV DNA on 50-pooled sample nucleic acid amplification testing (NAT). Lookback study showed that the first donated blood was negative for HBV DNA on 50-pooled sample NAT but positive on individual sample NAT (ID-NAT). Before transfusion, the patient was negative for HBsAg and anti-HBc. HBV DNA sequence analysis of the patient and of the donor showed 99% homology. Lamivudine treatment was started, and prevented acute hepatitis B. The present patient was a member of the ID-NAT screening study for post-transfusion infection. In eight of 921 patients (excluding the present patient), HBV DNA was detected only after blood transfusion. Seven of these eight patients were positive for anti-HBc was positive and four had been transfused during chemotherapy for neoplasm. Retrospective study of all donor samples showed no detection of HBV DNA by ID-NAT. Recently it was reported that cytotoxic chemotherapy induced HBV reactivation in patients with past HBV infection. We therefore speculate that HBV reactivation occurred in some of our eight patients positive for HBV DNA after blood transfusion.
