Donor screening for antibody to hepatitis B core antigen and hepatitis B virus infection in transfusion recipients.
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.
Mosley
J W
JW
University of Southern California, Los Angeles.
Stevens
C E
CE
Aach
R D
RD
Hollinger
F B
FB
Mimms
L T
LT
Solomon
L R
LR
Barbosa
L H
LH
Nemo
G J
GJ
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
D006508:Hepatitis Antibodies; D006512:Hepatitis B Core Antigens