anti-HBc Screening Research Articles

Anti-HBc screening for the prevention of perinatal transmission of hepatitis B virus in France.

As anti-HBc screening has been proposed for blood donor testing, we investigated its effectiveness during pregnancy. Among 4,023 successive pregnant women screened for anti-HBc, 539 (13.4%) were positive and further tested for HBsAg and anti-HBs. HBsAg was found in 73 (1.81%) and anti-HBc only was positive in 66 (1.64%). Among the 73 women positive for HBsAg, HBV DNA was found in the serum of seven, the cord blood of two, the placenta of three. Of the 58 infants given HBV immunoglobulins and vaccine, only four had transient HBsAg. None of the 66 women positive for anti-HBc only had anti-HBc IgM, HBeAg, or HBV DNA in serum, cord blood or placenta but five women became HBsAg positive before, at, or after delivery. Among the infants born of these 66 mothers, three had high ALT, two had HBsAg and one HBV DNA without HBsAg. Screening for anti-HBc may be cost effective, at least in low HBV prevalence areas, since there is evidence for infectivity of pregnant women positive for anti-HBc only.

Evaluation of routine anti‐HBc screening of volunteer blood donors: a questionable surrogate test for non‐A, non‐B hepatitis

Routine antibody to hepatitis B core antigen (anti-HBc) screening, recommended as a surrogate test to identify potential carriers of non-A, non-B hepatitis, was evaluated on 22,346 blood donors using currently available enzyme immunoassay (EIA) reagents. Of the 2 percent found reactive, the majority had cutoff-to-sample absorbance ratios less than 2.0 and less than one-half had anti-HBc when tested by a radioimmunoassay (RIA) method. Only one of 2877 units donated previously by the reactive donors was implicated in a transfusion associated hepatitis case. These results raise questions about the use of currently available anti-HBc reagents as a surrogate test for non-A, non-B hepatitis.

Blood donors positive for HBsAg and negative for anti-HBc antibody.

From January 1980 to December 1983, 989,907 blood donations were screened for HBsAg. A total of 1,345 was found HBsAg positive; 33 of whom were negative for anti-HBc (2.45%); in 10 cases HBeAg was present at a low level along with HBsAg. 2 of the 33 subjects were lost to follow-up. Late serum samples were available for 28 blood donors, and clinical and biological data only were known for the 3 others. An evolution of HBV markers was observed in each case; anti-HBc antibody became positive in 24 subjects (the 4 remaining subjects had a very short follow-up); HBeAg was positive at a high titer in 18 subjects and seroconversion to anti-HBe was observed in 7 individuals; HBsAg concentration increased in 21 subjects from 2 to 4,000 times and decreased in the 7 others. Seroconversion to anti-HBs was observed in 8 individuals. According to these serological, biological and clinical findings, different outcomes were observed: in 6 subjects too short a follow-up was available to allow appropriate classification, but there was evidence to suggest all probably developed clinical hepatitis; in 6 subjects asymptomatic hepatitis with rapid loss of HBsAg occurred; in 2 subjects asymptomatic hepatitis with the persistence of HBsAg at a low level and seroconversion to anti-HBe occurred; and in 17 subjects clinical hepatitis developed. These observations establish that most of the 33 blood donors were infectious at the time of their blood donation, and that anti-HBc antibody screening must not replace HBsAg screening for blood donations.

Blood Donors Positive for HBsAg and Negative for Anti-HBc Antibody

From January 1980 to December 1983, 989,907 blood donations were screened for HBsAg. A total of 1,345 was found HBsAg positive; 33 of whom were negative for anti-HBc (2.45%); in 10 cases HBeAg was present at a low level along with HBsAg. 2 of the 33 subjects were lost to follow-up. Late serum samples were available for 28 blood donors, and clinical and biological data only were known for the 3 others. An evolution of HBV markers was observed in each case; anti-HBc antibody became positive in 24 subjects (the 4 remaining subjects had a very short follow-up) ; HBeAg was positive at a high titer in 18 subjects and seroconversion to anti-HBe was observed in 7 individuals; HBsAg concentration increased in 21 subjects from 2 to 4,000 times and decreased in the 7 others. Seroconversion to anti-HBs was observed in 8 individuals. According to these serological, biological and clinical findings, different outcomes were observed: in 6 subjects too short a follow-up was available to allow appropriate classification, but there was evidence to suggest all probably developed clinical hepatitis; in 6 subjects asymptomatic hepatitis with rapid loss of HBsAg occurred; in 2 subjects asymptomatic hepatitis with the persistence of HBsAg at a low level and seroconversion to anti-HBe occurred; and in 17 subjects clinical hepatitis developed. These observations establish that most of the 33 blood donors were infectious at the time of their blood donation, and that anti-HBc antibody screening must not replace HBsAg screening for blood donations.

The value of screening blood donors for antibody to hepatitis B core antigen.

Rapid counter-immunoelectrophoresis (CIE) and radioimmunoassay (RIA) methods for detecting antibody to hepatitis B core antigen (anti-HBc) were used to screen nearly 8000 blood donors, including 919 prisoners. The prevalence of anti-HBc in prisoner donors (3.4%) was significantly higher than that in other donors (0.7%). The three HBsAg positive donors in the series were all anti-HBc positive and, of the other 73 anti-HBc positive donors, 62 had antibody to HBsAg (anti-HBs). Two panels of control sera, including 155 HBsAg positive samples, were tested by CIE for anti-HBc: 149 of the 155 were anti-HBc positive. Of the six negative samples, four were HBsAg positive only by RIA. One of the panels, containing 16 weakly HBsAg positive samples, was available for anti-HBc testing by RIA. Fifteen of the samples were positive and the other was slightly reactive. Donor sera that gave unconfirmable reactions in initial CIE tests were invariably negative when tested by RIA. The RIA was a more sensitive and specific test for anti-HBc than CIE. The ways in which anti-HBc screening could meet the needs of blood transfusion centres are discussed. We suggest that, in areas of low prevalence, it has a role as a rapid confirmatory test of HBV infection and as a means of identifying those potentially infectious donations in which HBsAg cannot be detected.