Background: Screening for hepatitis B virus surface antigen (HBsAg) reduces the risk of transfusion-transmitted hepatitis B viral (HBV) infection. However, the absence of HBsAg in the blood of apparently healthy individuals may not be sufficient to ensure the lack of circulating HBV. Blood containing anti-hepatitis B core antibody (anti-HBc) without detectable presence of HBsAg might be infectious; therefore, screening for anti-HBc has been implemented in some countries resulting in a decrease in the risk of post-transfusion HBV infection.
Aim: To study the seroprevalence of anti-HBc. The relationship between anti-HBc positivity and the presence of circulating HBV among healthy blood donors negative for HBsAg will be helpful to decide whether supplemental testing may bring additional safety to blood products.
Material and methods: A total of 1026 serum samples collected from HBsAg-negative Egyptian healthy male donors were tested for the presence of anti-HBc (both IgM and IgG types) using the competitive enzyme-linked immunosorbent assay technique. Anti-HBc-positive samples were subjected to real-time polymerase chain reaction to confirm the presence of HBV DNA.
Results: Of the 1026 samples tested, 80 (7·8%) blood samples were found to be reactive to anti-HBc. Of those, HBV DNA was detected in five of the samples (6·25%). The levels of detected viraemia were variable among the five donors.
Conclusion: This study shows the insufficient effectiveness of HBsAg screening in protecting blood recipients from HBV infection. Inclusion of anti-HBc testing should be considered in the screening of blood donors.