A case of hepatitis B in a haemodialysis unit

A patient probably acquired hepatitis B virus (HBV) from a transfused infected unit of fresh frozen plasma. She had been on regular haemodialysis for four months before her infection was discovered. One hundred and seventy-six patients and 304 staff contacts were screened and there were no secondary cases. At donation the infected blood donor was hepatitis B surface antigen (HBsAg) negative but subsequently proved to be anti-hepatitis B core (HBc)-positive and positive for HBV DNA. Consideration should be given to screening blood donations for anti-HBc in addition to HBsAg. Vigilance needs to be maintained on dialysis units against sporadic cases of hepatitis B. All staff should be immunized and be able to demonstrate protective levels of anti-HBs.