98th Annual Meeting DOG 2000

V 678

Detection of Hepatitis B-DNA and C-RNA in the corneoscleral discs and organ culture media of seropositive donors

U. Sengler1 , O. Adams2 , R. Sundmacher1

Background: According to the literature the prevalence of donors seropositive for hepatitis B (HbsAg) or C in the western countries is estimated to be around 1%. However, there are only very few cases published so far where a viral hepatitis has said to be transmitted by a penetrating keratoplasty. This is also true for the time before serological screening for infectious diseases became mandatory for corneal donors. In our cornea bank between 5 (HBV) and 3 (HCV) % of the corneas of the years 1995 to 1998 were discarded due to a positive serology. In about half of the cases the "positivity" was only questionable. This study is to evaluate the detectability of hepatitis B-DNA and hepatitis C-RNA in the corneas and culture media of donors tested seropositive for HbsAg or HCV-Ak.

Methods: In this study were investigated 36 corneas of 20 donors seropositive for HbsAg and 27 corneas of 14 donors seropositive for HCV-Ak. The corneoscleral discs were divided into a central trephinate (7 mm) and the corneoscleral rim and examined separately by Polymerase-Chain-Reaction (PCR). Additionnally the organ culture media and the sera were screened by PCR for the presence of HBV-DNA or HCV-RNA.

Results: HBV-DNA or HCV-RNA could not be detected in the organ culture media. In the corneas no HBV-DNA could be detected either, concerning the HCV-RNA the PCR-test are currently underway.

Conclusion: According to our results the risk of transmitting a viral hepatitis by penetrating keratoplasty seems to be very low. In case of donors with only questionably positive serology we think that transplantation could be considered. In case of a definitly positive serology we will further exclude these corneas from transplantation and will continue to investigate the corneoscleral discs for the presence of viral genomes to evaluate the risk of a transmission.

1 Lions-Corneabank NRW and Eye Hospital, 2 Institute of Med. Microbiology and Virology, Heinrich Heine University, Moorenstr. 5, D-40225 Düsseldorf