{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T23:04:08Z","timestamp":1784761448111,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,5,1]],"date-time":"2020-05-01T00:00:00Z","timestamp":1588291200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Hepatitis B virus (HBV) infection is one of the major concerns for the safety of blood transfusion in high\u2010prevalent countries such as in China. Prior studies outside of China have shown hepatitis B surface antigen (HBsAg) false\u2010reactive rate of 0.02% to 0.04%. Similarly, false\u2010negative HBsAg and HBV DNA results may occur in infected donors. Our study analyzed HBsAg enzyme\u2010linked immunosorbent assay (ELISA)\u2010reactive but NAT\u2010negative donations in Shenzhen Blood Center, China.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY DESIGN AND METHODS<\/jats:title><jats:p>HBsAg ELISA\u2010positive\/NAT\u2010negative plasma samples identified from screening 101,025 donations during 2017\u20102018 were analyzed by molecular and serologic tests including neutralization, chemiluminescence immunoassays, and various HBV DNA amplification assays. Molecular characterizations of HBsAg\u2010positive\/NAT\u2010negative samples were determined by quantitative polymerase chain reaction (qPCR) and nested PCR amplification of the basic core and precore promotor regions (295 base pairs) and HBsAg (S) region (496 base pairs).<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Screening of 101,025 eligible blood donations identified 157 (0.16%, 95% confidence interval, 0.13%\u20100.18%) HBsAg ELISA\u2010positive\/NAT\u2010negative plasma samples; of those, 71 (45.2%) were HBsAg confirmed positive by further HBsAg testing and DNA positive by molecular tests with increased sensitivity. Of the 71, all but one was antibody to hepatitis B core antigen reactive without antibody to hepatitis B surface antigen, yielding one recent (window\u2010period) HBV infection. Of the remaining donations, 80 (51%) were not considered as HBV\u2010infected donors, and 6 (3.8%) were interpreted as indeterminate since HBsAg results were discordant with unconfirmed HBV DNA results. In the 71 confirmed positives, HBsAg levels ranged from 0.05 to 400\u2009IU\/mL and HBV DNA from 6 to 2654 IU\/mL; however, the correlation between the two was weak (R<jats:sup>2<\/jats:sup> =\u20090.24).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>Fewer than half of HBsAg ELISA\u2010positive\/NAT\u2010negative samples were confirmed as HBsAg positive. Our study demonstrates that in highly HBV\u2010endemic countries, assays with high sensitivity and specificity may be required.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.15824","type":"journal-article","created":{"date-parts":[[2020,5,2]],"date-time":"2020-05-02T03:19:16Z","timestamp":1588389556000},"page":"1476-1482","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Comprehensive analysis of hepatitis B virus infections in blood donors in southern China that are surface antigen positive but nucleic acid testing negative"],"prefix":"10.1111","volume":"60","author":[{"given":"Xianlin","family":"Ye","sequence":"first","affiliation":[{"name":"Shenzhen Blood Center  Shenzhen Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Li","sequence":"additional","affiliation":[{"name":"Shenzhen Blood Center  Shenzhen Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruohao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Shenzhen Blood Center  Shenzhen Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heng","family":"Liu","sequence":"additional","affiliation":[{"name":"Shenzhen Blood Center  Shenzhen Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinfeng","family":"Zeng","sequence":"additional","affiliation":[{"name":"Shenzhen Blood Center  Shenzhen Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenxu","family":"Hong","sequence":"additional","affiliation":[{"name":"Shenzhen Blood Center  Shenzhen Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Lu","sequence":"additional","affiliation":[{"name":"Shenzhen Blood Center  Shenzhen Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weigang","family":"Zhu","sequence":"additional","affiliation":[{"name":"Shenzhen Blood Center  Shenzhen Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shilin","family":"Li","sequence":"additional","affiliation":[{"name":"Provincial Key Laboratory for Transfusion\u2010transmitted Infectious Diseases Institute of Blood Transfusion, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC)  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6715-3616","authenticated-orcid":false,"given":"Min","family":"Xu","sequence":"additional","affiliation":[{"name":"Provincial Key Laboratory for Transfusion\u2010transmitted Infectious Diseases Institute of Blood Transfusion, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC)  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaobo","family":"Wu","sequence":"additional","affiliation":[{"name":"Provincial Key Laboratory for Transfusion\u2010transmitted Infectious Diseases Institute of Blood Transfusion, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC)  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limin","family":"Chen","sequence":"additional","affiliation":[{"name":"Provincial Key Laboratory for Transfusion\u2010transmitted Infectious Diseases Institute of Blood Transfusion, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC)  Chengdu Sichuan China"},{"name":"Toronto General Research Institute University Health Network, University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"WHO. Hepatitis B factsheet. Available from:http:\/\/www.who.int\/mediacentre\/factsheets\/fs204\/en\/2017."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0094528"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2012.01.003"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2893.2007.00910.x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23886"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.2003.00386.x"},{"key":"e_1_2_8_8_1","first-page":"6","article-title":"Characterisation and follow\u2010up study of occult hepatitis B virus infection in anti\u2010HBc\u2010positive qualified blood donors in southern China","volume":"15","author":"Ye X","year":"2017","journal-title":"Blood Transfus"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12653"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2893.2006.00741.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2002-04-1084"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2018.00029"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.13819"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.14784"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.2011.01506.x"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12178"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12190"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2012.03909.x"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12198"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.14050"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.13381"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0042-9007.2001.00125.x"},{"key":"e_1_2_8_23_1","first-page":"2061","article-title":"Relationship between HBV DNA load and levels of serum HBsAg in patients with chronic hepatitis B","volume":"20","author":"Zhu HY","year":"2016","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.2001.41091107.x"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.2003.00424.x"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2004.04055.x"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.25592"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.24186"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.15824","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/trf.15824","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.15824","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T23:41:39Z","timestamp":1693957299000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.15824"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5]]},"references-count":27,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2020,7]]}},"alternative-id":["10.1111\/trf.15824"],"URL":"https:\/\/doi.org\/10.1111\/trf.15824","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5]]},"assertion":[{"value":"2019-07-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}