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Occult hepatitis B viral infection in voluntary donors
Croatia (CroMSIC) - Josip Juraj Strossmayer University of Osijek, Osijek
Department of Transfusion Medicine
Marina Samardzija, Domagoj Drenjancevic
Type of Research Project
- Clinical Project with Laboratory work
What is the background of the project?
Hepatitis B is a disease which is caused by the hepatitis B virus. The chronic type of disease can be developed within 5% - 10% in the adult population who has been infected. Although an incurable disease, chronic hepatitis B is treated in order to decrease heavy consequences of chronic disease, cirrhosis and hepatocellular carcinoma. Hepatitis B virus is most commonly sexually transmitted, by injections intravenous drugs and transmitted from a mother to her baby, but also iatrogenic, especially on those patients which are submitted to immunosuppressive therapy. Necessary vaccination decreases risk from this infection, as well as from infection transferred by transfused blood. Among chronically infected patients, 3-15% of them has the occult type of HBV infection which is characterized by HBV-DNA and negative finding of HBsAg (antigen on the surface of HBV). Occult HBV disease is the most common cause of posttransfussion hepatitis B in immunocompromised patients. Hepatitis B viral infection represents a major public health problem. In order to reduce the transmission of hepatitis B through blood transfusion and because of the inability to detect occult hepatitis B viral infection by serological methods, molecular ID-NAT testing was introduced.
What is the aim of the project?
To determine the prevalence of occult hepatitis B infection among blood donors and preventing transmission of hepatitis B by blood transfusion.
What techniques and methods are used?
Study population are voluntary blood donors that donate their blood in Clinical hospital Osijek during one month. At first, questionnaire is going to be given to the blood donors which questions the health state of voluntary blood donors, it determines if donors have any concealed illness. Before observing results from the serology and molecular tests, the student will check if the questionnaire of the patient indicates any concealed illnesses. Secondly, serology methods are conducted with the blood sample : (HBsAg, antibody on the antigen of the core of HBV virus (anti-HBC), antibody on the antigen of the surface of HBV virus (anti-HBS)). At the end, a molecular method ID-NAT (Individual donor-nucleic acid testing) is conducted to the blood sample for human immunodeficiency virus-1, hepatitis C virus and hepatitis B virus and its role in blood safety. ID – NAT is a quality test on HIV-1 RNA (human immunodeficiency virus-1 ribonucleotide acid), HCV RNA (hepatitis C ribonucleotide acid) and HBV DNA). The outcome is reporting back with results to hospital unit which claim suspect on infection.
What is the role of the student?
- The student will mainly observe
- The student will observe the practical experiments but will be highly involved in the analysis of the results
- The tasks will be done under supervision
What are the tasks expected to be accomplished by the student?
The student’s role is to find out and study about the results of serological and molecular testings. Before observing results from the serology and molecular tests, the student will check if the questionnaire of the patient indicates any concealed illnesses. The student’s role is to determine if look back or trace back procedure has been commenced. “Look back” procedure is a way which enables us to determine if a multiple blood donor has been infected with a cause which is transmitted by blood, wherefore the disease could be transmitted to the recipient of the composition prepared out of the last dose for which the negative result has been obtained. “Trace back” procedure is a way of managing when a transfusional institution receives information about the existing of an objective suspicion that one patient has been infected by blood transfusion and blood derivates. The student’s role is to examine if the donors have visited the advisory center before the donation due to the possibility of health issues.
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
Yes, to study literature in the references, it is provided by the tutor
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- The student will prepare a scientific report - No specific outcome is expected
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
Subjects passed: internal medicine, infectology
Are there any legal limitations in the student’s involvement
Type of students accepted
This project accepts: - Medical students - Graduated students (less than 6 months)
- • Three-Year Experience in NAT Screening of Blood Donors for Transfusion Transmitted Viruses in Croatia. Safic Stanic H; Babic I; Maslovic M; Dogic V; Bingulac-Popovic J; Miletic M; Jurakovic-Loncar N; Vuk T; Strauss-Patko M; Jukic I. Transfus Med Hemother. 2017 Nov;44(6):415-420.
- • Diagnosis of hepatitis B. Song JE; Kim DY. Ann Transl Med. 2016 Sep; 4(18): 338.
- • Occult HBV Infection: A Faceless Enemy in Liver Cancer Development. Morales-Romero J; Vargas G; García-Román R. Viruses. 2014 Apr; 6(4): 1590–1611.
- • Sufficient blood; safe blood: can we have both? Bönig H; Schmidt M; Hourfar K; Schüttrumpf J; Seifried E. BMC Med. 2012 Mar 23;10:29.
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