Occult Hepatitis B Infection among Blood Donors in Pointe Noire, Republic of the Congo

Brunel Monic Angounda^{1, 2,} , Serge Oscar Mokono^{2, 3}, Fabien Roch Niama^{1, 4}, Anicet Luc Magloire Boumba^{3, 5}, Viny Andzi Elenga¹, Edwige Paola Chancelle Louanga Nanitelamio², Renée Sorine Akouala², Geneviève Boukatou², Arsène Bikoue² and Gabriel Ahombo¹

¹Faculty of Sciences and Technology, Marien Ngouabi University, Brazzaville, Republic of the Congo

²National Center of Blood Transfusion, Brazzaville, Republic of the Congo

³Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Republic of the Congo

⁴National Public Health Laboratory, Brazzaville, Republic of the Congo

⁵Microbiology and Molecular Biology Department, Loandjili General Hospital, Pointe Noire, Republic of the Congo

Cite this paper:
Brunel Monic Angounda, Serge Oscar Mokono, Fabien Roch Niama, Anicet Luc Magloire Boumba, Viny Andzi Elenga, Edwige Paola Chancelle Louanga Nanitelamio, Renée Sorine Akouala, Geneviève Boukatou, Arsène Bikoue and Gabriel Ahombo. Occult Hepatitis B Infection among Blood Donors in Pointe Noire, Republic of the Congo. American Journal of Infectious Diseases and Microbiology. 2025; 13(1):1-4. doi: 10.12691/ajidm-13-1-1

Abstract

Background: Occult hepatitis B infection (OBI) is one of the most important transfusion safety issues and is considered a potential risk for hepatitis B virus (HBV) transmission. The aim of this study was to evaluate the prevalence and characteristics of OBI among blood donors in Pointe Noire. Methods: A cross-sectional study conducted among blood donors at Pointe Noire between October 2019 and May 2020. Blood samples from blood donors negative for hepatitis B surface antigen (HBsAg) were included. HBsAg and hepatitis B core antibodies (HBcAb) were done by ELISA. HBV DNA was detected by nucleic acid testing (NAT) and sequencing of preS1 region was done to determine HBV genotypes. Results: Out of 350 samples tested, 283 (80.9%) were males and 67 (19.1%) females. The mean age was 32.4 ± 12.3 years (range 18–60 years). The rate of anti-HBc was 33.43% (117/350) and the OBI prevalence was 2.3% (8/350). All samples were identified HBV genotype E and multiple mutations in preS1 region were observed in 75% of samples. Majority substitutions were: sA35E in 5 cases, sH44L and T52R in 4 cases, sR38G in 3 cases, S89T and Q92V in 2 cases, sN97R and I108L in 1 case. OBI rate and mutations were unrelated to gender, age, donor group and genotypes. Conclusions: This study highlights the significant prevalence of occult HBV in blood donors, indicating that HBsAg screening of blood donors is not sufficient and should be improved by anti-HBc and HBV DNA screening.

Keywords:
Hepatitis B virus occult genotype blood donors transfusion Congo

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	Schaefer, S., Hepatitis B Virus Taxonomy and Hepatitis B Virus Genotypes, World journal of gastroenterology, 13 (1), 14. January 2007.
[2]	Kramvis, A., Genotypes and Genetic Variability of Hepatitis B Virus, Intervirology, 57 (3–4), 141–150. July 2014.
[3]	Kramvis, A., Kew, M.C., Epidemiology of Hepatitis B Virus in Africa, Its Genotypes and Clinical Associations of Genotypes. Hepatology Research, 37 (s1). July 2007.
[4]	Hollinger, F.B., Hepatitis B Virus Infection and Transfusion Medicine: Science and the Occult, Transfusion, 48 (5). May 2008.
[5]	Yuen, M.F., Ka Ho Wong, D., Lee, C.K., Tanaka, Y., Allain, J.P., Fung, J., Leung, J., Lin, C.-K., Sugiyama, M., Sugauchi, F., Transmissibility of Hepatitis B Virus (HBV) Infection through Blood Transfusion from Blood Donors with Occult HBV Infection, Clinical Infectious Diseases, 52 (5), 624–632. March 2011.
[6]	Nna, E., Mbamalu, C., Ekejindu, I. Occult Hepatitis B Viral Infection among Blood Donors in South–Eastern Nigeria. Pathogens and Global Health, 108 (5), 223-228. Jul 2014.
[7]	Hu, K., Occult Hepatitis B Virus Infection and Its Clinical Implications. Journal of viral hepatitis, 9 (4), 243–257. June 2002.
[8]	Stramer, S.L., Wend, U., Candotti, D., Foster, G.A., Hollinger, F. B., Dodd, R. Y., Allain, J.P., Gerlich, W., Nucleic Acid Testing to Detect HBV Infection in Blood Donors, New England Journal of Medicine, 364 (3), 236–247. January 2011.
[9]	Makuwa, M., Bakouetela, J., Bassindikila, A., Samba-Lefebvre, M., Etude Des Marqueurs Sérologiques de l’hépatite B Chez Les Patients Congolais Testés Pour l’infection à VIH. Médecine d’Afrique Noire, 4. April 1996.
[10]	Elira-Dokekias, A., Okandze-Elenga, J., Dzia-Lepfounzou, A., Parra, H., Prévalence Des Marqueurs Viraux Majeurs Chez Les Donneurs de Sang à Brazzaville. Gazette Transfusion, 117, 4-6, 2002.
[11]	Taty taty, R., Yala, F., Courouce, A., Arthaud, M., Saliou, P., Biendo, M., Wassoumbou, E., Prevalence of chronic carriage of Hbs ag and anti-Hbc in brazzaville (congo)-seroepidemiologic survey in health-workers and general-population, Bulletin de la Societe de Pathologie Exotique, 83 (2), 149–154, 1990.
[12]	Stuyver, L., De Gendt, S., Van Geyt, C., Zoulim, F., Fried, M., Schinazi, R.F., Rossau, R., A New Genotype of Hepatitis B Virus: Complete Genome and Phylogenetic Relatedness, Journal of general virology, 81 (1), 67–74. January 2000.
[13]	Tamura, K., Stecher, G., Peterson, D.,Filipski, A., Kumar, S., MEGA6: Molecular Evolutionary Genetics Analysis Version 6.0. Molecular biology and evolution, 30 (12), 2725-2729. December 2013.
[14]	Allain, J.P., Occult Hepatitis B Virus Infection, Transfusion clinique et biologique, 11 (1), 18-25. February 2004.
[15]	García-Montalvo, B.M., Ventura-Zapata, L.P., Molecular and Serological Characterization of Occult Hepatitis B Infection in Blood Donors from Mexico, Annals of hepatology, 10 (2), 133-141. June 2016.
[16]	Hassan, A.G., Yassin, M.E. and Mohammed, A.B., Molecular Detection and Sero-Frequency Rate of Occult Hepatitis B Virus among Blood Donors in Southern Darfur State (Sudan), African Journal of Medical and Health Sciences, 2(9). 2017.
[17]	Oluyinka, O.O., Tong, H.V., Bui Tien, S., Fagbami, A.H., Adekanle, O., Ojurongbe, O., Bock, C.T., Kremsner, P.G., Velavan, T.P., Occult Hepatitis B Virus Infection in Nigerian Blood Donors and Hepatitis B Virus Transmission Risks, PLoS ONE, 10 (7). July 2015.
[18]	Seo D.H, Whang D.H, Song E.Y, Kim H.S, Park Q, Prevalence of antibodies to hepatitis B core antigen and occult hepatitis B virus infections in Korean blood donors Transfusion 51 1840–6. February 2011.
[19]	Alshayea, A.I., Eid, G.E., El-Hazmi, M.M., Alhetheel, A.F., Prevalence and Characterization of Occult Hepatitis B Infection among Blood Donors in Central Saudi Arabia, Saudi medical journal, 37 (10), 1114–1119. October 2016.
[20]	El‐Zayadi, A., Ibrahim, E., Badran, H., Saeid, A., Moneib, N., Shemis, M., Abdel‐Sattar, R., Ahmady, A., El‐Nakeeb, A., Anti‐HBc Screening in Egyptian Blood Donors Reduces the Risk of Hepatitis B Virus Transmission, Transfusion medicine, 18 (1), 55-61. February 2008.
[21]	Rios-Ocampo, W. A., Cortes-Mancera, F., Olarte, J. C., Soto, A., Navas, M.C., Occult Hepatitis B Virus Infection among Blood Donors in Colombia, Virology journal, 11, 1-10. November 2014.
[22]	Yuan, Q., Ou, S.H., Chen, C.R., Ge, S.X., Pei, B., Chen, Q.R., Yan, Q., Lin, Y.C., Ni, H.Y., Huang, C.H., Yeo, A.E.T., Shih, J.W.K., Zhang, J., Xia, N.S., Molecular Characteristics of Occult Hepatitis B Virus from Blood Donors in Southeast China. J Clin Microbiol, 48 (2), 357-362. February 2010.
[23]	Candotti, D., Grabarczyk, P., Ghiazza, P., Roig, R., Casamitjana, N., Iudicone, P., Schmidt, M., Bird, A., Crookes, R., Brojer, E., Characterization of Occult Hepatitis B Virus from Blood Donors Carrying Genotype A2 or Genotype D Strains, Journal of hepatology, 49 (4), 537-547. October 2008.
[24]	Zheng, X., Ye, X., Zhang, L., Wang, W., Shuai, L., Wang, A., Zeng, J., Candotti, D., Allain, J.-P., Li, C., Characterization of Occult Hepatitis B Virus Infection from Blood Donors in China, J Clin Microbiol, 49 (5), 1730–1737. May 2011.
[25]	Melegari, M., Scaglioni, P.P., Wands, J. R., The Small Envelope Protein Is Required for Secretion of a Naturally Occurring Hepatitis B Virus Mutant with Pre-S1 Deleted, Journal of virology, 71 (7), 5449–5454. July 1997.
[26]	Hsieh, Y.H., Su, I.J., Wang, H.C., Chang, W.W., Lei, H.Y., Lai, M.D., Chang, W.T., Huang, W., Pre-S Mutant Surface Antigens in Chronic Hepatitis B Virus Infection Induce Oxidative Stress and DNA Damage, Carcinogenesis, 25 (10), 2023–2032. October 2004.