title: Significance of screening antibodies to hepatitis B virus core antigen among Syrian blood donors.
abstract: BACKGROUND
  Hepatitis B virus (HBV) transmission via hepatitis B surface antigen (HBsAg)-negative blood donors has been reported. While many countries have implemented screening antibodies to hepatitis B core antigen (anti-HBc) to further enhance transfusion safety, HBsAg is still the only obligatory HBV screening test of blood donors in Syria.
  
  
  OBJECTIVE
  To evaluate the significance of screening anti-HBc to reduce the risk of transfusion transmitted HBV infection in Syria.
  
  
  METHODS
  A cohort cross-sectional prospective study included 1939 healthy blood donors assigned at the blood transfusion center of Damascus University. All donors were tested for HBsAg and anti-HBc. HBsAg-negative, anti-HBc-positive sera were further tested quantitatively for antibodies to hepatitis B surface antigen (anti-HBs) and 'anti-HBc alone' sera were considered for HBV quantitative real time polymerase chain reaction (qPCR).
  
  
  RESULTS
  Among 1913 HBsAg-negative donors, 215 (11·2%) were anti-HBc-positive including 125 anti-HBs high-positive and 59 anti-HBs low-positive donors. The remaining 31 donors were 'anti-HBc alone', five of which were HBV DNA-positive.
  
  
  CONCLUSIONS
  Our results suggest including anti-HBc as an additional screening test for blood donors in Syria to reduce the risk of HBV transmission. As the most cost-effective measure, anti-HBc-positive donors should be tested quantitatively for anti-HBs and only donors with no or low (<100 IU L(-1) ) anti-HBs should be deferred.
authors.affiliation: Department of Biochemistry and Microbiology, Faculty of Pharmacy, Damascus University, Damascus, Syria. wael.muselmani@hotmail.com
authors.forename: W
authors.initials: W
authors.lastname: Muselmani
authors.forename: W
authors.initials: W
authors.lastname: Habbal
authors.forename: F
authors.initials: F
authors.lastname: Monem
mesh_terms: D001782:Blood Donors; D003430:Cross-Sectional Studies; D046148:Donor Selection / Q000379:methods*; D005260:Female; D006509:Hepatitis B / Q000097:blood* / Q000276:immunology / Q000517:prevention & control / Q000635:transmission; D006510:Hepatitis B Antibodies / Q000097:blood* / Q000276:immunology; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006515:Hepatitis B virus / Q000276:immunology*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013593:Syria
chemical_list: D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens
keywords: Syria; anti-HBc; anti-HBc alone; blood donors; occult HBV infection