Hepatitis B core IgM antibodies (anti HBcIgM), a serological marker for eradicating transfussion associated hepatitis B virus (TAHBV) infection in low income countries

Abstract

Background: The safety of blood products is one of the major problems concernedwith the transfusionmedicine. A definite hazard of transmission of hepatitis B to recipients of blood screen for Hepatitis B surface Antigen (HBsAg) when such donor is at the ‘window phase’ exist. The possibility of achieving zero risk of Transfusion Associated Hepatitis B Virus (TAHBV) infection is highly dependent on DNA testing of all collected units of blood before transfusion. This is not feasible in low income countries including Nigeria due to cost. At present, HBsAg detection is the only diagnostic screening test for HBV infection identification in the blood transfusion centers of Nigeria. Hepatitis B core IgM antibody (anti-HBc IgM) is gaining prominence as a useful alternative in reducing TAHBV infection. The present study was aimed at evaluating adoption of anti-HBc IgM an additional screening assay for blood donation since anti-HBc detection is not mandatory in Nigeria. Methods & Materials: Two hundred and seventy-three (Male =246, F =27; Age range:18-50 Mean:24.9years) apparently healthy blood donors in Ibadanwere enrolled in the study between October andDecember2012; their demographicdatawasobtained. The frequency of HBsAg and its corresponding antibody (HBsAb), as well as Hepatitis B envelope antigen and its corresponding antibody (HBeAg and Ab) were assessed using standard enzyme link Immunosorbent assay EELISA) technique. Anti-HBcIgM was also assessed in donors negative or positive for HBsAg using same method. Results: The prevalence of anti-HBc IgM was 4.4%. Twelve (11 Males and 1 female) had anti-HBc IgM as the only marker of HBV infection. Prevalence of HBsAg, HBsAb, HBeAg and HBeAb were 14(5.1%), 95(34.8%), 2(14.3%) and 3(21.4%) respectively. Conclusion: The findings of the current study recommends that all blood units should be tested for anti -HBc IgM to understand the infectivity status of the blood donors in the window period and to discardblood if zero risk of TransfusionAssociatedHepatitis BVirus (TAHBV) infection will be achieved in Nigeria.