2018 Volume 64 Issue 1 Pages 35-42
A patient without a prior history of hepatitis B was found to be positive for antibodies to the hepatitis B e antigen (anti-HBe) after blood transfusion. Several subsequent studies revealed that the anti-HBe positivity was donor-derived. This experience prompted us to conduct a study on the anti-HBe positivity in blood products and the blood kinetics of donor-derived anti-HBe after transfusion. We studied the positivity rate of anti-HBe in 1,064 bags of residual plasma of either 240 ml of fresh frozen plasma (FFP) or 10 units of platelet concentrate (PC). Anti-HBe was detected in 24 bags (2.3%), which were transfused to 18 anti-HBe- negative patients. We studied the kinetics of donor-derived anti-HBe in these 18 patients after transfusion. Anti-HBe positivity in these patients lasted more than three months but was transient, and higher anti-HBe titer transfusions were associated with higher detection rates of anti-HBe. All 18 patients were negative for hepatitis B virus DNA (HBV DNA) using the TaqMan gene expression assay and antibodies against the hepatitis B core antigen, suggesting that there was no possibility of transfusion-transmitted HBV infection. Our results indicate that careful consideration is required when interpreting positive anti-HBe results after transfusion.
