American Red Cross experience with routine testing for hepatitis B core antibody

Area of Science:

• * Immunology
• * Public Health
• * Transfusion Medicine

Background:

• * Hepatitis B virus (HBV) infection remains a significant global health concern.
• * Screening blood donations for HBV markers is crucial for transfusion safety.
• * Hepatitis B core antibody (anti-HBc) testing identifies past or present HBV infection.

Purpose of the Study:

• * To characterize the performance of routine anti-HBc testing in a large donor population.
• * To analyze the variability of anti-HBc positivity across different regions and seasons.
• * To validate predictions from a prior pilot study on anti-HBc testing impact.

Main Methods:

• * Analysis of anti-HBc test results from 2.3 million blood donations.
• * Geographical and temporal analysis of anti-HBc-positive rates.
• * Case-control study to assess the consistency of anti-HBc positivity in repeat donors.

Main Results:

• * Routine anti-HBc testing reproducibly identified a distinct donor population.
• * Anti-HBc-positive rates showed significant variation by region within the continental United States.
• * Seasonal fluctuations in anti-HBc-positive rates were observed.
• * 85% of subsequent donations from anti-HBc-positive donors were also anti-HBc positive.

Conclusions:

• * Routine anti-HBc testing is effective in identifying a specific donor group.
• * Geographical and temporal factors influence anti-HBc prevalence in blood donors.
• * The study confirmed the performance and impact of anti-HBc testing as predicted.
• * Consistent positivity in repeat donations supports the test's reliability.