A PATIENT TRANSFUSED WITH HBV-DNA-POSITIVE PLATELET CONCENTRATE NEGATIVE ON 50-POOL NUCLEIC ACID AMPLIFICATION TESTING

Post-transfusion hepatitis is presently a rare side effect of blood transfusion. It is not possible to exclude all donor blood in the window period when blood is not yet positive for serological tests of Hepatitis B virus (HBV) after HBV infection. If a patient is transfused with blood obtained in the window period which includes a small HBV load, he or she may develop post-transfusion hepatitis B. On 20 September 2000, a patient in our institution with acute leukemia was transfused with 10 units of platelet concentrate negative for HBV-DNA on the 50-pool nucleic acid amplification test (NAT). Blood given by the same donor on 19 October 2000 was positive for HBV-DNA by 50-pool NAT. On retrospective study, the blood transfused into our patient was found to be positive for HBV-DNA by individual NAT. However, HBV-DNA load in the blood was less than 100 copies/ml. Our patient was followed for seven months after the blood transfusion containing HBV-DNA, but HBV infection did not occur. This finding indicates that post-transfusion hepatitis B will not necessarily develop following transfusion with 50-pool NAT HBV-DNA-negative blood from a hepatitis B-infected patient. HBV infection is thought to be more closely related to transferred HBV load and the recipient patient's physical condition.