Vj. Martlew et al., HEPATITIS-B CORE ANTIBODY SCREENING OF VOLUNTARY BLOOD-DONORS - AN EXTENDED PILOT-STUDY USING A MODIFIED PASSIVE HEMAGGLUTINATION ASSAY, TRANSFUSION MEDICINE, 3(3), 1993, pp. 229-235
Screening for hepatitis B surface antigen (HBsAg), even by the most se
nsitive techniques, fails to detect all carriers of the hepatitis B vi
rus (HBV). The presence of hepatitis B core antibody (anti-HBc) in the
absence of HBsAg is a common finding in donors implicated in cases of
post-transfusion hepatitis B (PTHB), and viral DNA may also be demons
trated in many of these individuals. An extended pilot study of routin
e screening of all donations for anti-HBc in addition to HBsAg was int
roduced into the Mersey and North Wales Regional Transfusion Service i
n November 1991 to improve surveillance for carriers of HBV. In order
to reduce costs a modified passive have a sensitivity of 99% and speci
ficity of 98% compared with a conventional assay. In the first 6 month
s 60 530 donations were tested and 12 (0.02%) were found to have anti-
HBc in the absence of HBsAg or adequate antibodies to HBsAg (anti-HBs)
. These sera will later be submitted for polymerase chain reaction (PC
R) testing in order to determine their infectivity or other-wise by th
e detection HBV DNA sequences.