Department of Medicine, Maulana Azad Medical College, University of Delhi, New Delhi, India.
Indian J Med Res. 2010 Sep;132:312-7.
BACKGROUND & OBJECTIVES: Expansions of blood donor screening and improved laboratory detection of viral markers have remarkably reduced the risk for infection with transfusion-transmitted viruses. This study was aimed to evaluate the presence of anti-HBc and to determine the presence or absence of HBV DNA in the serum samples from HBsAg negative, anti-HBc positive blood donors in a tertiary care hospital blood bank from Delhi.
A total of 2175 HBsAg negative, first time volunteer blood donors were included in the study from blood bank, Lok Nayak Hospital, New Delhi. The blood specimens from all these subjects were evaluated for anti-HBV-core antigen (anti-HBc) serology, anti-HBV-surface antigen (anti-HBs) titres and HBeAg. The presence of HBV DNA was evaluated by testing, through polymerase chain reaction (PCR) techniques.
Of the 2175 HBsAg negative voluntary blood donors, 413 (19.8%) were tested to be positive for anti-HBc alone. Of these, 153 (group-I) were anti-HBs negative whereas group-II comprises a total of 260 anti-HBs positive cases i.e. 89 out of 413 had anti-HBs titres of 10-99 IU/l and the remaining 171 had anti-HBs titres of 100-500 IU/l. HBV DNA was detected in 7.5 per cent anti-HBc positive samples irrespective of anti-HBs status.
INTERPRETATION & CONCLUSION: Our results showed that 18.9 per cent of our donor population was anti-HBc reactive, and hence inclusion of anti-HBc testing will lead to a high discard rate. The presence of HBV DNA in fairly high percentage of anti-HBc positive samples highlighted the need for a stringent and better screening system to prevent occult HBV infection.
通过扩大献血者筛查范围和改进实验室检测病毒标志物，经输血传播的病毒感染风险已显著降低。本研究旨在评估乙型肝炎核心抗体（抗-HBc）的存在情况，并确定德里一家三级护理医院血库中乙型肝炎表面抗原（HBsAg）阴性、抗-HBc 阳性献血者血清样本中是否存在乙型肝炎病毒（HBV）DNA。
本研究共纳入 2175 名 HBsAg 阴性、首次献血的志愿者，均来自新德里洛克纳亚克医院血库。对所有这些受试者的血液标本进行乙型肝炎核心抗原（抗-HBc）血清学、乙型肝炎表面抗原（抗-HBs）滴度和 HBeAg 检测。通过聚合酶链反应（PCR）技术检测 HBV DNA 的存在情况。
在 2175 名 HBsAg 阴性的志愿献血者中，有 413 名（19.8%）单独检测出抗-HBc 阳性。其中，153 名（I 组）抗-HBs 阴性，而 II 组共包括 260 例抗-HBs 阳性病例，即 413 例中有 89 例抗-HBs 滴度为 10-99IU/L，其余 171 例抗-HBs 滴度为 100-500IU/L。无论抗-HBs 状态如何，均在 7.5%的抗-HBc 阳性样本中检测到 HBV DNA。
我们的结果表明，我们的献血人群中有 18.9%的人对抗-HBc 有反应，因此包括抗-HBc 检测将导致较高的淘汰率。相当高比例的抗-HBc 阳性样本中存在 HBV DNA，这突出表明需要建立严格和更好的筛查系统，以防止隐匿性乙型肝炎感染。
