title: Anti-HBc Screening of Blood Donors in Bangladesh: Relevance to Containment of HBV Propagation.
abstract: OBJECTIVE
  To avoid further transmission of hepatitis B virus (HBV) infection, blood is tested for hepatitis B surface antigen (HBsAg) before transfusion. However, post-transfusion hepatitis B has been detected in clinics after transfusion of HBsAg-negative blood. The study presented here was undertaken to assess if HBsAg-negative blood is free from HBV or not.
  
  
  METHODS
  Sera were collected from 398 blood donors who were negative for HBsAg. Out of 398 blood samples, antibody to hepatitis B core antigen (ant-HBc) was detected in 82 sera samples. HBV DNA was evaluated in HBsAg-negative, anti-HBc-positive sera. HBsAg, hepatitis B e antigen (HBeAg), antibody to HBeAg (anti-HBe), and anti-HBc in the sera were measured by an enzyme-linked immunosorbent assay (ELISA). HBV DNA was quantified by a real time polymerase chain reaction (PCR).
  
  
  RESULTS
  Out of 82 HBsAg-negative, anti-HBc-positive sera samples, HBV DNA were detected in the sera of 7 voluntary blood donors. Out of these 7 subjects, all were negative for HBeAg. The levels of ALT were more than 30 IU/L in 6 of 7 HBVDNA-positive subjects and it was above upper limit of normal (>42 IU/ml) in one subject.
  
  
  CONCLUSIONS
  The present recommendation about blood transfusion of HBsAg-negative blood system is not capable of blocking HBV transmission to blood recipients. Although advanced countries have adopted nucleic acid testing (NAT) for preventing HBV transmission, developing countries may apply anti-HBc testing and ALT estimation before blood transmission.
authors: Department of Virology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
authors: Munira
authors: M
authors: Jahan
authors: Department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
authors: Md Asadul
authors: MA
authors: Islam
authors: Department of Medical Sciences, Toshiba General Hospital, Tokyo, Japan.
authors: Sheikh Mohammad Fazle
authors: SM
authors: Akbar
authors: Department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
authors: Kazuaki
authors: K
authors: Takahashi
authors: Department of Virology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
authors: Shahina
authors: S
authors: Tabassum
authors: Department of Virology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
authors: Atiar
authors: A
authors: Rahman
authors: Department of Virology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
authors: Md Atiqul
authors: MA
authors: Haque
authors: Department of Virology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
authors: Joly
authors: J
authors: Biswas
authors: Department of Medical Sciences, Toshiba General Hospital, Tokyo, Japan.
authors: Shunji
authors: S
authors: Mishiro
authors: Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
authors: Mamun
authors: M
authors: Al-Mahtab
keywords: ALT; CHB, chronic hepatitis B; ELISA, enzyme-linked immunosorbent assay; ETV, entecavir; HBV DNA; HBV DNA, hepatitis B virus deoxyribonucleic acid; HBV, hepatitis B virus; HBeAg, hepatitis B virus e antigen; HBsAg, hepatitis B virus surface antigen; HBsAg-negative donor; NA, nucleoside analog; PCR, polymerase chain reaction; Peg IFN, pegylated interferon; anti-HBc; blood transfusion; hepatitis B