title: Donor screening for antibody to hepatitis B core antigen and hepatitis B virus infection in transfusion recipients.
abstract: 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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: University of Southern California, Los Angeles.
authors.forename: J W
authors.initials: JW
authors.lastname: Mosley
authors.forename: C E
authors.initials: CE
authors.lastname: Stevens
authors.forename: R D
authors.initials: RD
authors.lastname: Aach
authors.forename: F B
authors.initials: FB
authors.lastname: Hollinger
authors.forename: L T
authors.initials: LT
authors.lastname: Mimms
authors.forename: L R
authors.initials: LR
authors.lastname: Solomon
authors.forename: L H
authors.initials: LH
authors.lastname: Barbosa
authors.forename: G J
authors.initials: GJ
authors.lastname: Nemo
mesh_terms: D001782:Blood Donors; D006508:Hepatitis Antibodies / Q000032:analysis*; D006509:Hepatitis B / Q000635:transmission*; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006801:Humans; D016133:Polymerase Chain Reaction; D065227:Transfusion Reaction
chemical_list: D006508:Hepatitis Antibodies; D006512:Hepatitis B Core Antigens