Blood donation screening for hepatitis B virus core antibodies: The importance of confirmatory testing and initial implication for rare blood donor groups

Fu, Michael X.; Ingram, Jennifer; Roberts, Courtney; Nurmi, Visa; Watkins, Emma; Dempsey, Nina; Golubchik, Tanya; Breuer, Judith; Brailsford, Su; Irving, William L.; Andersson, Monique; Simmonds, Peter; Harvala, Heli

Abstract

Background and Objectives
Exclusion of blood donors with hepatitis B virus (HBV) core antibodies (anti-HBc) prevents transfusion-transmitted HBV infection but can lead to significant donor loss. As isolated anti-HBc positivity does not always indicate true past HBV infection, we have investigated the effectiveness of confirmatory anti-HBc testing and the representation of rare blood groups in anti-HBc-positive donors.

Materials and Methods
Three hundred ninety-seven HBV surface antigen-negative and anti-HBc initially reactive blood donor samples were tested by five different anti-HBc assays.

Results
Eighty percentage of samples reactive in Architect anti-HBc assay were positive by the Murex assay and anti-HBc neutralization. Eleven out of 397 samples showed discordant results in supplementary testing from the Murex confirmatory test result, and five remained undetermined following extensive serological testing. Thirty-eight percentage of anti-HBc-positive donors identified as minority ethnic groups compared with 11% representation in anti-HBc-negative donors (p < 0.0001); the frequency of the Ro blood group in anti-HBc-positive donors was 18 times higher in non-white ethnic groups.

Conclusion
Using two anti-HBc assays effectively enabled the identification of HBV-exposed and potentially infectious donors, their deferral and potential clinical follow-up. However, the exclusion of confirmed anti-HBc-positive donors will still impact the supply of rare blood such as Ro.

• Journal Article Type: Article
• Acceptance Date: Feb 9, 2024
• Online Publication Date: Feb 28, 2024
• Publication Date: Feb 28, 2024
• Deposit Date: Mar 1, 2024
• Publicly Available Date: Mar 1, 2024
• Journal: Vox Sanguinis
• Print ISSN: 0042-9007
• Electronic ISSN: 1423-0410
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1111/vox.13608
• Keywords: Anti-HBc testing; donor re-entry; ethnic groups; HBV screening; rare blood groups
• Public URL: https://nottingham-repository.worktribe.com/output/31896595
• Publisher URL: https://onlinelibrary.wiley.com/doi/full/10.1111/vox.13608