A patient probably acquired hepatitis B virus (HBV) from a transfused
infected unit of fresh frozen plasma. She had been on regular haemodia
lysis for four months before her infection was discovered. One hundred
and seventy-six patients and 304 staff contacts were screened and the
re were no secondary cases. At donation the infected blood donor was h
epatitis B surface antigen (HBsAg) negative but subsequently proved to
be anti-hepatitis B core (HBc)-positive and positive for HBV DNA. Con
sideration should be given to screening blood donations for anti-HBc i
n addition to HBsAg. Vigilance needs to be maintained on dialysis unit
s against sporadic cases of hepatitis B. All staff should be immunized
and be able to demonstrate protective levels of anti-HBs.