Transfusion transmission of hepatitis A virus with fecal shedding in a previously hepatitis A vaccinated recipient

• Published in: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy Vol. 24; no. 9; pp. 766 - 768
• Main Authors: Vestergaard, Hanne Thang, Harritshøj, Lene Holm, Midgley, Sofie Elisabeth, Ullum, Henrik, Kampmann, Peter
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.09.2018
• Subjects: Adult; Blood Transfusion - methods; Feces - virology; Female; Hepatitis A - immunology; Hepatitis A - transmission; Hepatitis A - virology; Hepatitis A Antibodies - immunology; Hepatitis A shedding; Hepatitis A Vaccines - immunology; Hepatitis A virus - immunology; Hepatitis A virus - isolation & purification; Humans; Leukemia, Myeloid, Acute - immunology; Leukemia, Myeloid, Acute - virology; Post-exposure prophylaxis; Post-Exposure Prophylaxis - methods; Transfusion Reaction - virology; Transfusion transmission; Transient infection; Vaccination - methods; Post-exposure prophylaxis; Transfusion transmission; Transient infection; Hepatitis A shedding
• ISSN: 1341-321X; 1437-7780
• DOI: 10.1016/j.jiac.2018.01.020

We describe a rare case of hepatitis A virus (HAV) replication in feces despite presence of hepatitis A antibodies in an acute myeloid leukemia (AML) patient after transfusion with HAV contaminated platelets. The patient has been vaccinated against HAV years before the AML diagnosis. Transient infection and reshedding should thus be considered in antibody-positive hematological patients. Transfusion associated HAV transmission is rare, and little evidence exists on the clinical consequences and possible effect of treatment with immunoglobulin. Further reporting on fecal shedding despite antibodies are needed, as HAV antibody levels are used as course of action for post-exposure prophylaxis and infection control.