Seroreactivity of antibodies to hepatitis B core antigen among hepatitis B surface antigen‐screened negative blood donors and its implications for blood safety in a resource‐constrained country

Abstract

AbstractBackground and ObjectivesTransfusion‐related hepatitis B infections have been reduced significantly with the implementation of blood screening using both serology and nucleic acid amplification technology (NAT) in developed countries. However, in resource‐constrained countries, where NAT is inaccessible, the risk persists from early acute and occult cases. This study aimed to determine the antibodies to hepatitis B core antigen (anti‐HBc) reactive rate among hepatitis B surface antigen (HBsAg)‐screened negative blood donors and its impact on blood safety in the Philippines.Materials and MethodsA total of 1602 HBsAg‐negative samples, randomly collected from nine leading blood service facilities representative of each region in the Philippines, were tested for anti‐HBc immunoglobulin M (IgM), Total and antibodies to HBsAg (anti‐HBs) using the Architect i2000SR Immunoassay Analyser (Abbott Laboratories, IL). Anti‐HBc IgM and/or Total repeat reactive were further tested for hepatitis B virus (HBV) NAT using the Cobas TaqScreen MPX v2.0 (Roche Diagnostics, Basel).ResultsOverall, 19.16% HBsAg‐negative samples (n = 307/1602) were reactive for either anti‐HBc IgM or Total or a combination of both, of which 1.3% (n = 4/307) had detectable HBV‐DNA and 80.5% (n = 247/307) were anti‐HBs positive. About the anti‐HBs titres, 30.27% (n = 485/1602) were positive (≥10 IU/L) with 55.67% (n = 270/485) having titres ≥100 IU/L. Anti‐HBs‐only‐positive samples were 14.85% (n = 238/1602).ConclusionWe observed a high anti‐HBc reactive rate (19.16%) with 3.7% anti‐HBc‐only reactive (anti‐HBs negative) and 1.3% HBV‐DNA positive. This warrants the need to reconsider existing screening practices to improve blood safety in the country.