Risk Factors and Anti‐HBc Reactivity among First Time Blood Donors

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Abstract
Background and objectives: 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. Materials and methods: 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. Results: 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. Conclusion: 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.
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