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Prepublished online as a Blood First Edition Paper on May 31, 2002; DOI 10.1182/blood-2002-03-0798.
Submitted March 14, 2002
Accepted May 4, 2002
Frequency and load of hepatitis B virus DNA in first-time blood donors with antibodies to hepatitis B core antigen
Holger Hennig*, Ines Puchta, Jurgen Luhm, Peter Schlenke, Siegfried Goerg, and Holger Kirchner
Institute of Immunology and Transfusion Medicine, University of Lubeck, Lubeck, Germany
* Corresponding author; email: hennig{at}immu.mu-luebeck.de.
The objective of this study was to determine the frequency and load of 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 post-transfusion HBV infection. 14,251 first-time blood donors were tested for anti-HBc using a microparticle enzyme immunoassay; positive results were confirmed by a second ELISA. For the detection of HBV DNA from plasma samples we developed a novel and highly sensitive real-time PCR assay. The 95% detection limit of the method amounted to 27.8 IU/ml, consistent with the WHO international standard for HBV DNA. 216 blood donors (1.52%) tested anti-HBc-positive in both tests. 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- 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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