Detection and significance of anti-HBc in the blood bank; preliminary results of a controlled prospective study.

It has been suggested that post-transfusion hepatitis B (PTHB) may occur after transfusion with blood negative for hepatitis B surface antigen (HBsAg) but positive for antibody against hepatitis B core antigen (anti-HBc). We are currently conducting a controlled prospective study of recipients of such blood to investigate this possibility. Blood donors were routinely screened for HBsAg by radioimmunoassay (RIA) and those found negative were tested for anti-HBc by RIA. The HBsAg negative, anti-HBc positive donors were then tested by antibody directed against HBsAg by RIA, antibody directed against hepatitis B 'e' antigen by enzyme-immunoassay and for the liver enzymes SGOT and SGPT. To date,, follow-up has been completed in the recipients of 141 anti-HBc positive blood donors and in a control group of the recipients of 141 anti-HBc negative blood donors. All the recipients were bled repeatedly with intervals of 4--5 weeks up to 7 months post-transfusion. Currently, no clear-cut seroconversion was observed in recipients of either group for any of the antibody markers of HBV infection. While none of the 141 recipients of anti-HBc negative blood became positive for HBsAg, 3/141 recipients of anti-HBc positive blood acquired HBsAg and developed clinically manifest post-transfusion hepatitis B.