{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T16:05:35Z","timestamp":1784649935937,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T00:00:00Z","timestamp":1682985600000},"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":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hepatitis B virus (HBV)\u2010positive individuals with isolated anti\u2010HBs are found among HBV vaccine recipients and healthy blood donors with no vaccination history. HBV infectivity from blood transfusions derived from such individuals remains unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Presentation<\/jats:title><jats:p>A male patient who received transfusion with blood negative for individual donation\u2010NAT, HBsAg and anti\u2010HBc but weakly positive for anti\u2010HBs developed typical transfusion\u2010transmitted (TT)\u2010HBV with anti\u2010HBc response. The responsible blood donor was a frequent repeat donor showing a marked increase in anti\u2010HBs titer without anti\u2010HBc response 84\u2009days after index donation. Test results for his past donations showed transient viremia with very low viral load and fluctuating low\u2010level anti\u2010HBs. The HBV vaccination history of this donor was unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Anti\u2010HBs and anti\u2010HBc kinetics of the donor suggest a second antibody response to new HBV challenge, representing a vaccine breakthrough case. On the other hand, transient low\u2010level viremia and fluctuating anti\u2010HBs in the test results of past donations suggested chronic occult HBV infection with isolated anti\u2010HBs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Whatever the basic infection state, blood donors with isolated weak anti\u2010HBs may include a small population with a risk of causing TT\u2010HBV. Identifying individuals harboring such TT\u2010HBV risk among individuals positive only for anti\u2010HBs is difficult under current screening strategies. Active surveillance for the occurrence of TT\u2010HBV with blood positive only for anti\u2010HBs is necessary.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.17390","type":"journal-article","created":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T12:48:57Z","timestamp":1683031737000},"page":"1250-1254","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Transfusion\u2010transmitted <scp>HBV<\/scp> infection with isolated <scp>anti\u2010HBs<\/scp>\u2010positive blood"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4660-6839","authenticated-orcid":false,"given":"Masahiro","family":"Satake","sequence":"first","affiliation":[{"name":"Central Blood Institute, Japanese Red Cross  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoji","family":"Yamagishi","sequence":"additional","affiliation":[{"name":"Central Blood Institute, Japanese Red Cross  Tokyo 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