Assessing Occult HBV Infection Risk: Serological Markers and HBV-DNA PCR in HBsAg-Negative Blood Donors in Ilorin, Nigeria

Abstract

Introduction: Blood transfusion is essential in medicine but carries risks of blood transmission infections like the Hepatitis B virus (HBV). Research has revealed the existence of occult HBV infection where Individuals with no detectable HBsAg habor HBV DNA in their liver or blood. Diagnosis of HBV in developing countries typically relies on detecting HBsAg; however, this method alone does not eliminate the risk of transmission and may overlook occult infections. Implementing enhanced screening protocols such as HBV DNA detection, is vital for improving blood safety against HBV transmission. This study aims to identify strategies to reduce the risks associated with transfusion-related HBV infection using blood donors recruited in Ilorin, Nigeria. Methods: One hundred and ninety-five (195) healthy blood donors were recruited from hospitals in Ilorin, Nigeria. Detailed pre-donation questionnaires were administered to the donors in an interviewer based manner. Venous blood was collected from all the donors into a plain bottle for serological screening with the help of expert laboratory scientists, and the test results were kept confidential. A colloidal gold immunochromatography assay was done to detect HBV antibodies (Anti-HBs, HBeAg, Anti-HBe, and Anti-HBc) using Multipanel HBV 5-in-1 rapid kit as instructed by the manufacturer. The viral marker HBsAg was detected using One Step Cassette Style HBV Test. Real- time polymerase chain reaction (R-TPCR) was done to detect HBV DNA. Data obtained was analyzed through Statistical Package for the Social Sciences (SPSS) Version 25.0. Chi-square were used to test for the associations with statistical significance set at P<0.05. Results: Among the recruited 195 blood donors, 15 (7.69%) tested positive for HBsAg, and were excluded from the study. The remaining 180 HBsAg-negative donors were evaluated for HBV serologic markers. Family replacement donors, male donors, and those within age 26-35 exhibited the highest prevalence of demographic characteristics compared to commercial and voluntary donors, female donors, and other age groups (p=0.0000, 0.0000, 0.0001) respectively. First-time donors and individuals with one sexual partner were also notably associated with blood donation (p=0.0025 and p=0.012, respectively). No HBV DNA was detected in all HBsAg-negative donors. Also, 82 HBsAg-negative donors tested positive for HBV antibodies; 18 (10%) for Anti-HBs, 37 (20.5%) for Anti-HBc, 25 (13.8%) for Anti-HBs and Anti-HBc, and 2 (1.1%) for Anti-HBs, Anti-HBe, and Anti-HBc. Conclusion: This study reveals that FRD, male donors, those aged 26-35, first-time donors, and donors with one sexual partner are more likely to donate. Although, no HBsAg-negative sample tested positive for HBV DNA, but the results of serological markers indicated past exposure, raising concerns about occult infections. These findings emphasize the importance of intensifying HBV screening beyond the standard HBsAg test to the detection of HBV for a fuller picture of a donor's HBV status and to ensure safer blood transfusions.