Molijn M H, van der Linden J M, Ko L K, Gorgels J, Hop W, van Rhenen D J
Red Cross Bloodbank Rotterdam, The Netherlands.
Vox Sang. 1997;72(4):207-10. doi: 10.1046/j.1423-0410.1997.7240207.x.
The usefulness of testing for antibody to hepatitis B core antigen (anti-HBc) as a surrogate marker for non-A, non-B hepatitis can no longer be clearly established in the face of anti-hepatitis C virus testing. Application of anti-HBc testing in blood donors for detection of hepatitis B in addition to hepatitis B surface antigen testing (HbsAg) is a matter of debate.
We examined the serology and risk analysis data in a group of first-time blood donors. In 1.48% of 16,081 donors, anti-HBc reactivity was found. We invited a study group of 112 donors for extensive interviewing about the risk of blood transmissible diseases, and for serological testing. A control group of 240 first-time donors was studied as well.
In the study group, the age was older (p < 0.001), a history of liver disease was more frequent (p < 0.001), and the donor (p < 0.001) or the donor's partner (p < 0.05) had either stayed longer in an HBV-endemic area or had been born in one. Combining these with the serological results, we found that strong anti-HBc reactivity was related to hepatitis B risk factors in HBsAg-negative donors.
Anti-HBc testing in HbsAg-negative first-time donors makes it possible to identify hepatitis B risk factors with a prevalence of 0.02%. Our findings also stress the importance of including the history of the donor's partner(s) in the risk analysis before blood donation.
面对丙型肝炎病毒检测，将乙肝核心抗原抗体（抗-HBc）检测作为非甲非乙型肝炎替代标志物的有效性已无法明确确定。除乙肝表面抗原检测（HbsAg）外，在献血者中应用抗-HBc检测来检测乙肝是一个有争议的问题。
我们检查了一组首次献血者的血清学和风险分析数据。在16081名献血者中，有1.48%发现抗-HBc反应性。我们邀请了112名献血者组成研究组，就血液传播疾病风险进行广泛访谈，并进行血清学检测。还研究了240名首次献血者组成的对照组。
在研究组中，年龄较大（p < 0.001），有肝病病史的情况更常见（p < 0.001），献血者（p < 0.001）或其伴侣（p < 0.05）在乙肝流行地区停留时间更长或出生在该地区。将这些与血清学结果相结合，我们发现HbsAg阴性献血者中强抗-HBc反应性与乙肝风险因素有关。
对HbsAg阴性的首次献血者进行抗-HBc检测，有可能识别出患病率为0.02%的乙肝风险因素。我们的研究结果还强调了在献血前风险分析中纳入献血者伴侣病史的重要性。
