Reappraisal of screening strategy in hepatitis B surface antigen-negative blood donors: Correlation with hepatitis B virus-DNA quantification

BACKGROUND: In spite of screening for hepatitis B surface antigen (HBsAg), transfusion-associated hepatitis B virus (TAHBV) infection remains a serious public health problem due to transmission of HBV in window period and occult HBV infection. To avoid TAHBV infection, some health-care facilities have started Hepatitis B core antibody test along with HBsAg, but this leads to a lot of potential donor rejection who are not HBV infected. Our aim is to find a new protocol of donor screening to prevent TAHBV without compromising blood availability. MATERIALS AND METHODS: A total of 88 HBsAg-negative anti-HBc total positive blood donors were included in this study. All samples were also tested for anti-HBs by enzyme immunoassay and for the presence of HBV-DNA viral load by real-time polymerase chain reaction. RESULTS: A total of 88 HBsAg negative and anti-HBc, total positive blood donors were tested for anti-HBs and HBV-DNA (Qn.). Among them, 76 donors (86.4%) (males 73 and females 3) were found to be positive for anti-HBs, while rest 12 (13.6%) showed no detectable antibody against HBsAg. HBV-DNA was found to be positive in 4 (7.7%) donor samples among 52 (60%) who have anti-HBs level <100 mIU/ml, while 36 (40%) donor samples were found to have >100 mIU/ml anti-HBs antibody with no detectable HBV-DNA. CONCLUSION: HBV-DNA should be implemented as a screening test of the blood donors to prevent TAHBV infection without potential donor rejection.