A Rare Case of Transfusion Transmission of Hepatitis A Virus to Two Patients with Haematological Disease.

Autor:	da Silva SG; Serviço de Hemoterapia, HC1, Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brazil., Leon LA; Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil., Alves G; Coordenação de Pesquisa, Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brazil., Brito SM; Serviço de Hemoterapia, HC1, Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brazil., Sandes Vde S; Serviço de Hemoterapia, HC1, Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brazil., Lima MM; Serviço de Hemoterapia, HC1, Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brazil., Nogueira MC; Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil., Tavares Rde C; Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil., Dobbin J; Serviço de Hematologia, HC1, Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brazil., Apa A; Coordenação de Pesquisa, Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brazil., de Paula VS; Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil., Oliveira JM; Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil., Pinto MA; Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil., Ferreira Oda C Jr; Laboratório de Virologia Molecular, Instituto de Biologia da Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, Brazil., Motta Ide J; Serviço de Hemoterapia, HC1, Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brazil.
Jazyk:	angličtina
Zdroj:	Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie [Transfus Med Hemother] 2016 Mar; Vol. 43 (2), pp. 137-41. Date of Electronic Publication: 2015 Nov 24.
DOI:	10.1159/000441910
Abstrakt:	Background: This paper describes the transmission of hepatitis A virus (HAV) to two blood recipients from a healthy donor that later presented to the blood bank with jaundice. Methods: The RNA of HAV was detected by qualitative nested reverse transcription polymerase chain reaction (nested RT-PCR) and quantified by real-time RT-PCR. HAV RNA samples were genotyped by direct sequencing of PCR products. A sequence from a fragment of 168 bp from the VP1/2A HAV region was used to construct a phylogenetic tree. Case Report: A 31-year-old male donor accepted for donation of a whole blood unit returned to the blood bank with clinical jaundice 20 days after donation. His serological and NAT tests were negative for HBV and HCV. Serological tests for HAV IgM and IgG were negative on donation sample but positive on follow-up sample, confirming donor's HAV acute infection. Both recipients of red blood cells (R1) and platelet concentrate (R2) from the same implicated donation were HAV IgM-negative and IgG-positive. Qualitative PCR was positive on samples from all three individuals and phylogenetic analysis of viruses proved HAV transmission to the two recipients of blood products. HAV viral load on donor follow-up sample and the platelet recipient was 1.3 and 1.5 × 10(3) IU/ml, respectively. The RBC recipient, also infected by HCV, was undergoing bone marrow transplantation and died from fulminant hepatitis, 26 days after the implicated HAV transfusion. Conclusion: The blood donor, a garbage collector, spontaneously returned to the blood bank when developing jaundice. This highlights the importance of donor education to immediately report to blood banks of any signs and symptoms related to infectious disease developed after blood donation. The fact that one immunocompromised patient with HCV infection died from fulminant hepatitis after receiving a HAV-contaminated platelet transfusion underpins the importance of a HAV vaccination program for these group of patients.
Databáze:	MEDLINE
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