Indication of Anti-HBc Antibody Screening and HBV-DNA Detection in Diagnosing Latent Hepatitis B Virus Infection

Background: In spite of available, and sensitive screening assay for detection of hepatitis B virus surface antigen (HBsAg), occasional cases of post-transfusion hepatitis B virus infection are still observed. The aim of the present study was to assess the prevalence of positive anti hepatitis B core (anti-HBc) and presence of HBV-DNA in serum sample of healthy blood donors negative for both HBsAg and anti-HCV antibody. We evaluated whether anti-HBc could be adopted as a screening assay for blood donation. Material and Methods: Two thousands sera negative for both HBsAg and anti-HCV collected from healthy blood donors tested for presence of anti-HBc antibody. All sera positive for anti-HBc antibody were then investigated for determination of anti-HBc and anti-HBs titers, HbeAg and anti-HBe antibody by enzyme immunoassay (EIA). Every sample that tested negative for HBsAg but positive for anti-HBc alone or in combination with other serological markers was also examined for the presence of HBV-DNA by polymerase chain reaction (PCR). Results: Out of 2000 HBsAg negative blood samples, 131 samples (6.55%) were positive for anti-HBc. HBV-DNA was detected in 16 of 131(12.2%) anti-HBc positive specimens. The liver function test results were all in normal range except in 4 (25%) of 16 HBV-DNA positive subjects. Conclusion: Anti-HBc antibody should be tested routinely on blood donor volunteers, and if the sera become positive regardless of anti-HBs titer, the blood should be discarded. Further testing for HBV-DNA is appropriate to follow up the blood donor patient for HBV infection.Iran J Med Sci 2005; 30(1): 28-33. Keywords ● hepatitis B virus infection ● blood donors ● Iran ● anti-HBc ● HBV-DNA