title: A strategical re-thinking on National Blood Donor Pool: Anti-HBc positivity related re-entry mechanisms.
abstract: OBJECTIVE
  Screening of blood donations for antibodies against hepatitis B core antigen (anti-HBc) is used to prevent transfusion transmitted hepatitis B virus (HBV) infection. In this study, we studied the magnitude of blood donor gain by using a re-entry mechanism in our Blood Bank of Gulhane Military Academy of Medicine.
  
  
  METHODS
  Between January and May 2013, 5148 voluntary blood donors were screened by ELISA method for HBsAg, anti-HBc total and other screening markers, prospectively. Samples with repeated reactivity for the presence of anti-HBc were further tested with four supplemental assays.
  
  
  RESULTS
  We detected 515 (10%) anti-HBc positive and 4612 (90%) anti-HBc negative cases in 5127 HBsAg negative serum samples. A total of 461 (89.5%) blood units were reactive for at least one additional serologic parameter and 54 were (10.5%) negative. Isolated anti-HBc positivity rate was 1.3% (69/5127). In the isolated anti-HBc positive samples, 54 were also anti-HBe and HBeAg negative. HBV DNA was not detected in any of the samples.
  
  
  CONCLUSIONS
  Applying the EDQM criteria would decrease our blood donor loss from 10% to 5.4%. As alternative re-entry mechanisms have already been presented in the literature, institution of a new policy is needed to enhance the limited blood donor pool in our system.
authors.affiliation: Regional Blood Center, Gulhane Military Academy of Medicine, Ankara, Turkey. Electronic address: soyilmaz@gata.edu.tr.
authors.forename: Soner
authors.initials: S
authors.lastname: Yilmaz
authors.affiliation: Department of General Surgery, Gulhane Military Academy of Medicine, Ankara, Turkey.
authors.forename: Aytekin
authors.initials: A
authors.lastname: Unlu
authors.affiliation: Military Hospital, Isparta, Turkey.
authors.forename: Riza Aytac
authors.initials: RA
authors.lastname: Cetinkaya
authors.affiliation: Department of Medical Microbiology, Gulhane Military Academy of Medicine, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yapar
authors.affiliation: Department of Infectious Disease and Clinical Microbiology, Gulhane Military Academy of Medicine, Ankara, Turkey.
authors.forename: Ismail Yasar
authors.initials: IY
authors.lastname: Avci
authors.affiliation: Regional Blood Center, Gulhane Military Academy of Medicine, Ankara, Turkey.
authors.forename: Sebahattin
authors.initials: S
authors.lastname: Yilmaz
authors.affiliation: Department of Infectious Disease and Clinical Microbiology, Sanko University, Gaziantep, Turkey.
authors.forename: Can Polat
authors.initials: CP
authors.lastname: Eyigun
mesh_terms: D000328:Adult; D001782:Blood Donors; D046148:Donor Selection / Q000379:methods*; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006509:Hepatitis B / Q000097:blood*; D006510:Hepatitis B Antibodies / Q000097:blood*; D006512:Hepatitis B Core Antigens / Q000097:blood*; D006801:Humans; D008297:Male
chemical_list: D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens
keywords: Anti-HBc assays; Anti-HBs; Blood donor screening; HBV DNA; Transfusion-associated HBV