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Prepublished online as a Blood First Edition Paper on May 31, 2002; DOI 10.1182/blood-2002-03-0798.
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Blood, 1 October 2002, Vol. 100, No. 7, pp. 2637-2641
TRANSFUSION MEDICINE
Frequency and load of hepatitis B virus DNA in first-time blood
donors with antibodies to hepatitis B core antigen
Holger Hennig,
Ines Puchta,
Jürgen Luhm,
Peter Schlenke,
Siegfried Goerg, and
Holger Kirchner
From the Institute of Immunology and Transfusion
Medicine, University of Lübeck, Germany.
The objective of this study was to determine the frequency and load
of hepatitis B virus (HBV) DNA in anti-HBc-positive first-time blood
donors; it was designed to contribute to determining whether anti-HBc
screening of blood donations might reduce the residual risk of
posttransfusion HBV infection. A total of 14 251 first-time blood donors were tested for anti-HBc using a microparticle enzyme immunoassay; positive results were confirmed by a second
enzyme-linked immunosorbent assay (ELISA). For the detection of HBV DNA
from plasma samples, we developed a novel and highly sensitive
real-time polymerase chain reaction (PCR) assay. The 95% detection
limit of the method amounted to 27.8 IU/mL, consistent with the World Health Organization (WHO) international standard for HBV DNA. A total
of 216 blood donors (1.52%) tested anti-HBc-positive in both tests,
and 205 of them (16 HBsAg+, 189 HBsAg ) were tested for HBV DNA. In 14 (87.5%)
of the HBsAg-positive blood donors, HBV DNA was repeatedly detected,
and in 3 (1.59%) of the HBsAg-negative donors, HBV DNA was also found
repeatedly. In the 3 HBV DNA-positive, HBsAg-negative cases, anti-HBe
and anti-HBs (> 100 IU/L) were also detectable. HBV DNA in
HBsAg-negative as well as HBsAg-positive samples was seen at a low
level. Thus, HBV DNA is sometimes found in HBsAg-negative,
anti-HBc-positive, and anti-HBs-positive donors. Retrospective
studies on regular blood donors and recipients are necessary to
determine the infection rate due to those donations. Routine anti-HBc
screening of blood donations could probably prevent some
transfusion-transmitted HBV infections.
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