Donor screening for antibody to hepatitis B core antigen and hepatitis B virus infection in transfusion recipients.

  • Mosley J
  • Stevens C
  • Aach R
 et al. 
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BACKGROUND: Testing for antibody to hepatitis B core antigen (anti-HBc) as a surrogate for hepatitis C viremia is no longer needed for blood donor screening. Currently, the important question is how much its use supplements hepatitis B surface antigen (HBsAg) donor screening in preventing transfusion-transmitted hepatitis B virus (HBV) infection.

STUDY DESIGN AND METHODS: In a study conducted in the 1970s, 64 blood donors were associated with 15 cases of HBV (1.0%) in 1533 transfusion recipients. Sera from 61 donors at donation and 29 follow-up visits were available for present-day assays for HBsAg, HBV DNA, anti-HBc, and antibody to HBsAg (anti-HBs).

RESULTS: HBsAg was found in four previously negative blood donors; HBV DNA was limited to three of these four. Anti-HBc was detected in six HBsAg-negative donors. Two other donors were negative in all assays at donation, but positive for anti-HBc and anti-HBs 2 to 4 months later. The remaining donors were negative for all HBV markers, which left five recipient cases unexplained. No HBV transmission was observed when anti-HBs sample-to-negative control values were > or = 10.

CONCLUSION: Some 33 to 50 percent of cases of hepatitis B that could be transmitted by transfusion of blood from HBsAg-negative donors are prevented by anti-HBc screening. Anti-HBc-positive donors unequivocally positive for anti-HBs should be considered noninfectious for HBV and should be allowed to donate. Anti-HBc screening of paid plasmapheresis donors, supplemented by anti-HBs testing, would reduce the amount of HBV to be processed by virus inactivation and increase the content of anti-HBs in plasma pools.

Author-supplied keywords

  • Blood Donors
  • Blood Transfusion
  • Blood Transfusion: adverse effects
  • Hepatitis Antibodies
  • Hepatitis Antibodies: analysis
  • Hepatitis B
  • Hepatitis B Core Antigens
  • Hepatitis B Core Antigens: immunology
  • Hepatitis B: transmission
  • Humans
  • Polymerase Chain Reaction

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  • J W Mosley

  • C E Stevens

  • R D Aach

  • F B Hollinger

  • L T Mimms

  • L R Solomon

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