Blood donation screening for hepatitis B virus core antibodies: The importance of confirmatory testing and initial implication for rare blood donor groups




AuthorsFu MX, Ingram J, Roberts C, Nurmi V, Watkins E, Dempsey N, Golubchik T, Breuer J, Brailsford S, Irving WL, Andersson M, Simmonds P, Harvala H

Publication year2024

JournalVox Sanguinis

Journal name in sourceVox sanguinis

Journal acronymVox Sang

Volume119

Issue5

First page 447

Last page459

ISSN0042-9007

eISSN1423-0410

DOIhttps://doi.org/10.1111/vox.13608(external)


Abstract
BACKGROUND AND OBJECTIVES\nMATERIALS AND METHODS\nRESULTS\nCONCLUSION\nExclusion of blood donors with hepatitis B virus (HBV) core antibodies (anti-HBc) prevents transfusion-transmitted HBV infection but can lead to significant donor loss. As isolated anti-HBc positivity does not always indicate true past HBV infection, we have investigated the effectiveness of confirmatory anti-HBc testing and the representation of rare blood groups in anti-HBc-positive donors.\nThree hundred ninety-seven HBV surface antigen-negative and anti-HBc initially reactive blood donor samples were tested by five different anti-HBc assays.\nEighty percentage of samples reactive in Architect anti-HBc assay were positive by the Murex assay and anti-HBc neutralization. Eleven out of 397 samples showed discordant results in supplementary testing from the Murex confirmatory test result, and five remained undetermined following extensive serological testing. Thirty-eight percentage of anti-HBc-positive donors identified as minority ethnic groups compared with 11% representation in anti-HBc-negative donors (p < 0.0001); the frequency of the Ro blood group in anti-HBc-positive donors was 18 times higher in non-white ethnic groups.\nUsing two anti-HBc assays effectively enabled the identification of HBV-exposed and potentially infectious donors, their deferral and potential clinical follow-up. However, the exclusion of confirmed anti-HBc-positive donors will still impact the supply of rare blood such as Ro.



Last updated on 2025-27-01 at 18:39