Detection of Anti-HBc (Total) and HBV-DNA in Hepatitis B Virus Surface Antigen Negative Blood Donors

Hepatitis B virus (HBV) infection remains a critical global public health concern. The introduction of hepatitis B surface antigen (HBsAg) testing in routine blood donor screening during the early 1970s significantly improved transfusion safety. Despite this progress, cases of HBV transmission from blood components testing negative for HBsAg have been documented. Research indicates that some donors, while negative for HBsAg but positive for anti-HBc, can still replicate the hepatitis B virus. These donors may carry and sustain HBV-DNA in their liver and bloodstream, representing a latent source of HBV transmission. This cross-sectional study involved 300 HBsAg negative individuals who visited the Transfusion Medicine Department at Chittagong Medical College Hospital and the Shandhani Chittagong Medical College unit for blood donation between July 2016 and June 2017. Of these participants, 58.66% were voluntary donors, while 41.33% were replacement donors. The study revealed that the majority of participants were aged 21–30 years, with a mean age of 27.09 years. Males accounted for 83% of the donors, whereas females comprised 17%. The findings showed that 49 donors (16.3%) tested positive for anti-HBc (total) among the 300 HBsAg-negative donors. Anti-HBc (total) positivity was more prevalent among replacement donors (9.31%) compared to voluntary donors (7%), with the difference being statistically significant (P < 0.05). Among the anti-HBc (total) positive donors, 21 (42.9%) were HBV-DNA positive, while 32 (65.3%) were positive for anti-HBs. Risk behaviors such as a history of jaundice, prior surgery, blood transfusions, and a family history of hepatitis B virus infection were notable among these donors. In conclusion, the study underscores that relying solely on HBsAg for donor screening leaves a substantial number of HBV-infected donors unde- tected. Incorporating anti-HBc testing into donor screening protocols could substantially decrease HBV-infected donations, thereby reducing HBV transmission rates.