Evaluation of serologic screening of blood donors in India reveals a lack of correlation between anti-HBc titer and PCR-amplified HBV DNA.
BACKGROUND
Transfusion associated-HBV (TAHBV) is estimated at approximately 1.5 percent in postsurgical recipients and 50 percent or more in multiple-transfusion recipients in India. Not transfusing blood with high-titer anti-HBc, which reportedly correlates with the presence of HBV DNA, helped reduce TAHBV in Japan. This study tested anti-HBc-reactive donors for PCR-amplified HBV DNA and its correlation with anti-HBc titers.


METHODS
In total, 30,853 donors from Cohort 1 (24,694 in 2001) and Cohort 2 (6159 in 2000) were screened for anti-HBc and anti-HBs. Amplification of HBV DNA was performed on an unselected subset of 147 out of 3304 anti-HBc-only sera from Cohort 1 and 230 out of 6159 from Cohort 2. Correlation of anti-HBc titers in DNA positive (n = 48), DNA negative (n = 40), anti-HBs reactive (n = 44), and HBsAg reactive (n = 45) donors was by Fisher's exact test.


RESULTS
In Cohort 1, 2673 (10.82%) donors were reactive for anti-HBc, of whom 1038 (4.20%) were anti-HBc only. HBV DNA was detected in 40 out of 147 (27.21%) and 48 out of 230 (20.87%) donors with anti-HBc only from the two cohorts. Anti-HBc titers detected no significant difference between the first three groups.


CONCLUSIONS
Cryptic HBV infection was observed in approximately 25 percent of anti-HBc-only donors. No correlation was established between HBc titers and presence of HBV DNA.
D001782:Blood Donors; D004279:DNA, Viral / Q000097:blood*; D005500:Follow-Up Studies; D006510:Hepatitis B Antibodies / Q000097:blood*; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006801:Humans; D007194:India; D012698:Serologic Tests
D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens