Background and objectives: The usefulness of testing for antibody to h
epatitis B core antigen (anti-HBc) as a surrogate marker for non-A, no
n-B hepatitis can no longer be clearly established in the face of anti
-hepatitis C virus testing. Application of anti-HBc testing in blood d
onors for detection of hepatitis B in addition to hepatitis B surface
antigen testing (HbsAg) is a matter of debate. Materials and methods:
We examined the serology and risk analysis data in a group of first-ti
me blood donors. In 1.48% of 16,081 donors, anti-HBc reactivity was fo
und. We invited a study group of 112 donors for extensive interviewing
about the risk of blood transmissible diseases, and for serological t
esting. A control group of 240 first-time donors was studied as well.
Results: In the study group, the age was older (p < 0.001), a history
of liver disease was more frequent (p < 0.001), and the donor (p < 0.0
01) or the donor's partner (p < 0.05) had either stayed longer in an H
BV-endemic area or had been born in one. Combining these with the sero
logical results, we found that strong anti-HBc reactivity was related
to hepatitis B risk factors in HBsAg-negative donors. Conclusion: Anti
-HBc testing in HbsAg-negative first-time donors makes it possible to
identify hepatitis B risk factors with a prevalence of 0.02%. Our find
ings also stress the importance of including the history of the donor'
s partner(s) in the risk analysis before blood donation.