Significance of antibody to hepatitis B core antigen in blood donors as determined by their serologic response to hepatitis B vaccine

Abstract

Because large numbers of volunteer blood donors may be disqualified for "false-positive" results on tests for antibody to hepatitis B core antigen (anti-HBc), a more specific definition of anti-HBc enzyme immunoassay (EIA)-reactive was evaluated, including only those donor samples that were "strongly" reactive (sample-to-cutoff absorbance ratio, < 0.45). Results using this definition and other anti-HBc test methods were compared to the serologic response (antibody to hepatitis B surface antigen [anti-HBsAg]) to hepatitis B vaccination. Fifty-eight volunteer blood donors who had previously been deferred as donors, because of reactive anti-HBc tests (all other blood screening tests were negative, including those for HBsAg and anti-HBsAg) on two occasions, were vaccinated for hepatitis B. It was assumed that an anamnestic response to vaccine indicated past infection with hepatitis B, while a primary response to vaccine indicated lack of past infection. One (2%) of 43 donors with a historically "weak" anti-HBc (reactive absorbance ratio, > or = 0.45) had an anamnestic response to vaccine, compared to 8 (53%) of 15 with historically "strong" anti-HBc (reactive absorbance ratio, < 0.45) (p < 0.005). Anti-HBc testing using the microparticle EIA method also correlated well with hepatitis B vaccination results. The use of a narrower definition of "reactive" for anti-HBc EIA testing yielded much more specific, but slightly less sensitive, results.

Schistosoma mansoni Infection Can Jeopardize the Duration of Protective Levels of Antibody Responses to Immunizations against Hepatitis B and Tetanus Toxoid

“…This is within the expected range of non-response rate to hepatitis B vaccination of 4–10% [57,58] and these vaccine non-responders were excluded from the hepatitis B vaccine response analysis. The remaining 95 individuals (63% controls, 31% Sm+ and 6% STH+) all produced more than10 mIU/ml anti-HBs antibody levels after receiving the second or third dose of the vaccine series, indicating that they had achieved or exceeded the minimum level of protection.…”

Characterization of HBV DNA+/HBsAg− blood donors in Poland identified by triplex NAT

“…Some of them may have recovered from HBV infection, but anti-HBs is no longer detectable. Experimental approaches to differentiate results recovered from chronic cases in anti-HBc-only carriers might be either to monitor the antibody response to a dose of HBV vaccine 24,25 or to identify the presence of memory T cells responding to stimulation with the S antigen. 26 Compared to the previous group, the potential infectivity by transfusion is probably higher and has been described in some anecdotal cases.…”

Reducing the risk of hepatitis B virus transfusion-transmitted infection

“…The reason for this lies within the original development of anti-HBc tests. They were devised to test patients for suspected viral hepatitis rather than as a donor-screening assay and thus the sensitivity was increased over the specificity 44,45. Studies conducted in three low-prevalence countries (Germany, New Zealand, Switzerland) have shown that the anti-HBc tests currently used in blood bank settings have led to the loss of 2%, 2.5% and 6%–7%, respectively, of otherwise eligible donors 46–48.…”