Are isolated anti-Hbc blood donors in a high-risk group? The detection of HBVDNA in isolated anti-HBc cases with NAT nucleic acid amplification test based on transcription-mediated amplification

Abstract number: P2006

Kocazeybek B., Kosan E., Altunay H., Aslan M., Yenen O., Saribas S., Yuksel P., Birinci I., Kirali K., Aksoy A.

Aim: Hepatitis B virus (HBV) can be transmitted by blood transfusions even so using serological tests having high sensitivity and specificity. We aimed to detect HBV DNA in isolated anti-HBc donors and show if they have transfusion risk or not.

Method: We investigated Anti-Hbc and Anti-HBs in serum samples of 12858 HBsAg negative blood donors who were applied to the Turkish Redcrescent between June 2007-October 2008 by the Micro ELISA kit (Hepanostica ultra HBsAg, Bio Meriux, France). Anti-HBc and Anti-Hbs positive cases were omitted. We used Procleix ultrio (Chiro, USA) test kit (Chiron Tigris automated instrument was used) based TMA (Transcription Mediated Amplification) for NAT study in Anti-HBc positive and Anti-HBs negative serum samples. The discrimination of HBV in NAT positive samples were performed by Procleix Discrimination (Chiro, USA) test.

Results: 2748 (21.4%) Anti-HBc seropositivity were detected in 12852 HBsAg(-) serum samples. 23.5% Anti-HBs negativity was detected in 2748 Anti-HBc positive serum samples. On the other hand, 5.1% isolated Anti-Hbc positivity [HBsAg(-), Anti HBc(+), Anti-HBs(-)] were detected in 12852 HBsAg(-) serum samples. 0.091% and 0.047% HBV DNA positivity were detected in isolated Anti-HBc positive serum samples and HBsAg(-) serum samples, respectively.

Conclusion: As a result, even we have detected one (1) HBV transmission in every 2142 blood transfusion by HBsAg screening tests; we suggest that it is not necessary to add additional tests to detect isolated Anti-HBc for routine purposes in Blood Banking. The reasons are higher negativity rates (99%) of isolated Anti-HBc serum samples and the rejection of blood donors with Anti-HBc positivity and also additional tests (anti-HBc) are not being cost-effective.