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The Role of Hepatitis B Core Antibody Testing in Improving Blood Safety in Resource-Limited Countries Study on Voluntary Blood Donors Fayoum, Egypt

Abeer Mohamed Abdelrazik and Hossam M. Abdelaziz

Background: Transmission of hepatitis B virus (HBV) via hepatitis B surface antigen (HBsAg) negative blood donors has been reported. HBsAg is still the only mandatory HBV screening test of blood donors in Egypt due to high cost of DNA testing of all collected blood. Many resource- limited countries have implemented screening antibodies to hepatitis B core antigen (anti-HBc) to further improve transfusion safety. The objective of study was to evaluate the significance of screening anti-HBc to reduce the risk of transfusion transmitted HBV infection in Egypt.

Study Design and Methods: The study was conducted on 800 voluntary blood donors negative for HBsAg, hepatitis C antibody (HCVAb) and human immunodeficiency virus Ab. They were subjected to screening for anti- HBV core antibodies (total). Anti-HBc-positive samples were further tested for the antibodies to HBsAg (anti-HBs), and "anti-HBc alone" sera were tested for HBV DNA.

Results: Among 800 healthy voluntary donors, 99 (12.37%) were anti-HBc-positive including 78 anti-HBs positive. The remaining 21 donors were anti-HBc alone, 2 of which (9.52%) were HBV DNA-positive.

Conclusion: Greater consideration should be given to the implementation of anti-HBc as an additional screening test for blood donors in Egypt as the most cost-effective measure for further improvement of transfusion safety.