Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-f554764f5-fr72s Total loading time: 0 Render date: 2025-04-17T02:51:33.169Z Has data issue: false hasContentIssue false

2 - Antibody to hepatitis B core antigen

from Section 1 - Agents

Published online by Cambridge University Press:  12 January 2010

By
Joan O'Riordan
Edited by
John A. J. Barbara ,
Fiona A. M. Regan  and
Marcela Contreras
Joan O'Riordan
Affiliation:
Consultant Haematologist, Irish Blood Transfusion Service National Blood Centre, Dublin, Ireland
John A. J. Barbara
Affiliation:
University of the West of England, Bristol
Fiona A. M. Regan
Affiliation:
HNSBT and Hammersmith Hospitals NHS Trust, London
Marcela Contreras
Affiliation:
University of the West of England, Bristol
Get access

Summary

Introduction

In the mid-1980s some countries introduced blood donor screening for antibody to hepatitis B core antigen (anti-HBc) as a surrogate test for non-A, non-B hepatitis (Aymard et al., 1986; Koziol et al., 1986). Once anti-hepatitis C virus (HCV) antibody screening was implemented, anti-HBc testing was retained to reduce the risk of hepatitis B transmission and to detect populations at high risk of HIV infection. With data documenting the declining efficacy of anti-HBc as a surrogate marker for the prevention of HIV infection (Busch et al., 1997), anti-HBc screening has been retained to detect the rare hepatitis B virus (HBV) infectious, HBsAg negative donation (Busch, 1998). On a global level the frequency of anti-HBc is proportional to the prevalence of HBV in the population, with the highest prevalence rates in Asia and Africa, moderate rates in South and Central America and Southern Europe and lowest rates in Northern Europe and North America (Busch, 1998).

With the advent of nucleic acid amplification testing (NAT) of blood donations for HCV and HIV in North America and in many European countries, the role of anti-HBc screening and of mini-pool HBV DNA NAT is being investigated (Kleinman and Busch, 2001).

Hepatitis B virus serology

Please refer back to Chapter 1.

In general, in the immune response to hepatitis B infection, antibodies to the core of hepatitis B virus (IgM class followed by IgG) are the first antibodies produced and may be detected a few days after the appearance of HBsAg.

Type
Chapter
Information
Transfusion Microbiology , pp. 25 - 34
Publisher: Cambridge University Press
Print publication year: 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

References

Allain, J.-P. (2004) Occult hepatitis B virus infection: implications in transfusion. Vox Sang, 86, 83–91.CrossRefGoogle ScholarPubMed
Allain, J.-P., Hewitt, P. E., Tedder, R. S., et al. (1999) Evidence that anti-HBc but not HBV DNA testing may prevent some HBV transmission by transfusion. Br J Haematol, 107, 186–95.CrossRefGoogle Scholar
Barrio, Alvarez M., Diez, Gonzalez R., Sanchez, Hernandez J. M., et al. (2005) Residual risk of transfusion-transmitted viral infections in Spain, 1997–2002, and impact of nucleic acid testing. Euro Surveill, 10(2), 20–2.Google Scholar
Aoki, S. K., Finegold, D., Kuramoto, I. K., et al. (1993) Significance of antibody to hepatitis B core antigen in blood donors as determined by their serological response to hepatitis B vaccine. Transfusion, 33, 362–7.CrossRefGoogle Scholar
Aymard, J. P., Janot, G., Gayet, S., et al. (1986) Post-transfusion non-A, non-B hepatitis after cardiac surgery. Prospective analysis of donor blood anti-HBc antibody as a predictive indicator of the occurrence of non-A, non-B hepatitis in recipients. Vox Sang, 51, 236–8.CrossRefGoogle ScholarPubMed
Biswas, R., Tabor, E., Hsia, C. C., et al. (2003) Comparative sensitivity of HBV NATs and HBsAg assays for detection of acute HBV infection. Transfusion, 43, 788–98.CrossRefGoogle ScholarPubMed
Blajchman, M. A., Bull, S. B. and Feinman, S. V. (1995) Post-transfusion hepatitis: impact of non-A, non-B hepatitis surrogate tests. Canadian Post-transfusion Hepatitis Prevention Study Group. Lancet, 345, 21–5.CrossRefGoogle ScholarPubMed
Brojer, E. (2005) Implementation of donor screening for infectious agents transmitted by blood by nucleic acid technology in Poland. Vox Sang, 89, 267–8.CrossRefGoogle ScholarPubMed
Burger, R. O. R. (2005) Mitteilung des Arbeidskreises Blut des Bundesministeriums fur Gesundheit und Soziale Sicherung. Vottum 31 beide 58. Sitzung des Arbeitskreis Blut.
Busch, M. P. (1998) Prevention of transmission of hepatitis B, hepatitis C and human immunodeficiency virus infections through blood transfusion by anti-HBc testing. Vox Sang, 74 (Suppl. 2), 147–54.CrossRefGoogle ScholarPubMed
Busch, M. P. (2004) Should HBV DNA NAT replace HBsAg and/or anti-HBc screening of blood donors?Transfus Clin Biol, 11, 26–32.CrossRefGoogle ScholarPubMed
Busch, M. P., Dodd, R. Y., Lackritz, E. M., et al. (1997) Value and cost-effectiveness of screening blood donors for antibody to hepatitis B core antigen as a way of detecting window-phase human immunodeficiency virus type 1 infections. Transfusion, 37, 1003–11.CrossRefGoogle ScholarPubMed
Chambers, L. A. and Popovsky, M. A. (1991) Decrease in reported post-transfusion hepatitis. Contribution of donor screening for alanine aminotransferase and antibodies to hepatitis B core antigen and changes in the general population. Arch Intern Med, 151, 2445–8.CrossRefGoogle Scholar
Christensen, P. B., Titlestad, I. L., Homburg, K. M., et al. (2001) Hepatitis B core antibodies in Danish blood donors: a surrogate marker of risk behaviour. Vox Sang, 81, 222–7.CrossRefGoogle ScholarPubMed
Comanor, L. and Holland, P. (2006) Hepatitis B virus blood screening: unfinished agendas. Vox Sang, 91, 1–12.CrossRefGoogle ScholarPubMed
Dhedin, N., Douvin, C., Kuentz, M., et al. (1998) Reverse seroconversion of hepatitis B after allogeneic bone marrow transplantation: a retrospective study of 37 patients with pretransplant anti-HBs and anti-HBc. Transplantation, 66, 616–9.CrossRefGoogle ScholarPubMed
Dickson, R. C., Everhart, J. E., Lake, J. R., et al. (1997) Transmission of hepatitis B by transplantation of livers from donors positive for antibody to hepatitis B core antigen. The National Institute of Diabetes and Digestive and Kidney Diseases Liver Transplantation Database. Gastroenterology, 113, 1668–74.CrossRefGoogle Scholar
Dodd, R. Y., Notari, IV, E. P. and Stramer, S. L. (2002) Current prevalence and incidence of infectious disease markers and estimated window-period risk in the American Red Cross blood donor population. Transfusion, 42, 975–9.CrossRefGoogle ScholarPubMed
Dodson, S. F., Issa, S., Araya, V., et al. (1997) Infectivity of hepatic allografts with antibodies to hepatitis B virus. Transplantation, 64, 1582–4.CrossRefGoogle ScholarPubMed
Douglas, D. D., Rakela, J., Wright, T. L., et al. (1997) The clinical course of transplantation-associated de novo hepatitis B infection in the liver transplant recipient. Liver Transpl Surg, 3, 105–11.CrossRefGoogle ScholarPubMed
Dreier, J., Kroger, M., Diekman, J., et al. (2004) Low-level viraemia of hepatitis B virus in an anti-HBc- and anti-HBs-positive blood donor. Transfus Med, 14, 97–103.CrossRefGoogle Scholar
Flanagan, P., Charlewood, G., Horder, S., et al. (2005) Reducing the risk of transfusion transmitted hepatitis B in New Zealand. Vox Sang, 89(Suppl. 2), 23 (abstract).Google Scholar
Glynn, S. A., Kleinman, S. H., Wright, D. J., et al. (2002) International application of the incidence rate/window period model. Transfusion, 42, 966–72.CrossRefGoogle ScholarPubMed
Hennig, H., Puchta, I., Luhm, J., et al. (2002) Frequency and load of hepatitis B virus DNA in first-time blood donors with antibodies to hepatitis B core antigen. Blood, 100, 2637–41.CrossRefGoogle ScholarPubMed
Iizuka, H., Ohmura, K., Ishijima, A., et al. (1992) Correlation between anti-HBc titres and HBV DNA in blood units without detectable HBsAg. Vox Sang, 63, 107–11.CrossRefGoogle Scholar
Inaba, S., Miyata, Y., Ishii, H., et al. (2005) Hepatitis B transmission from an occult HB virus carrier. Transfusion, 45 (Suppl.), 94A (abstract).Google Scholar
Jackson, B. R., Busch, M. P., Stramer, S. L., et al. (2003) The cost-effectiveness of NAT for HIV, HCV and HBV in whole-blood donations. Transfusion, 43, 721–9.CrossRefGoogle ScholarPubMed
Japanese Red Cross non-A, non-B Hepatitis Research Group (1991) Effect of screening for hepatitis C virus and hepatitis B virus core antibody on incidence of post-transfusion hepatitis. Lancet, 338, 1040–1.CrossRef
Jongerius, J. M., Wester, M., Cuypers, H. T. M., et al. (1998) New hepatitis B virus mutant form in a blood donor that is undetectable in several hepatitis B surface antigen-screening assays. Transfusion, 38, 56–9.CrossRefGoogle Scholar
Kleinman, S. H. and Busch, M. P. (2001) HBV: amplified and back in the blood safety spotlight. Transfusion, 41, 1081–5.CrossRefGoogle Scholar
Kleinman, S. H., Kuhns, M. C., Todd, D. S., et al. (2003) Frequency of HBV DNA detection in US blood donors testing positive for the presence of anti-HBc: implications for transfusion transmission and donor screening. Transfusion, 43, 696–704.CrossRefGoogle ScholarPubMed
Kleinman, S., Strong, D. M., Tegtmeier, G. E., et al. (2005) Hepatitis B virus (HBV) DNA screening of blood donations in minipools with the COBAS AmpliScreen HBV test. Transfusion, 45, 1247–57.CrossRefGoogle ScholarPubMed
Koppelman, M., Assal, A., Chudy, M., et al. (2005) Multicenter performance evaluation of a transcription-mediated amplification assay for screening of human immunodeficiency virus-1 RNA, hepatitis C virus RNA, and hepatitis B virus DNA in blood donations. Transfusion, 45, 1258–66.CrossRefGoogle ScholarPubMed
Korelitz, J. J., Busch, M. P., Kleinman, S. H., et al. (1997) A method for estimating hepatitis B virus incidence rates in volunteer donors. Transfusion, 37, 634–40.CrossRefGoogle Scholar
Koziol, D. E., Holland, P. V., Alling, D. W., et al. (1986) Antibody to hepatitis B core antigen as a paradoxical marker for non-A, non-B hepatitis agents in donated blood. Annals of Internal Medicine, 104, 488–95.CrossRefGoogle ScholarPubMed
Kuhns, M. C., Kleinman, S. H., McNamara, A. L., et al. (2004) Lack of correlation between HBsAg and HBV DNA levels in blood donors who test positive for HBsAg and anti-HBc: implications for future HBV screening policy. Transfusion, 44, 1332–9.CrossRefGoogle ScholarPubMed
Marcellin, P., Giostra, E., Martinot-Peignoux, M., et al. (1991) Redevelopment of hepatitis B surface antigen after renal transplantation. Gastroenterology, 100, 1432–4.CrossRefGoogle ScholarPubMed
Matsumoto, C., Tadokoro, K., Fujimura, K., et al. (2001) Analysis of HBV infection after blood transfusion in Japan through investigation of a comprehensive donor specimen repository. Transfusion, 41, 878–84.CrossRefGoogle ScholarPubMed
Mine, H., Emura, H., Miyamoto, M., et al., (2003) High throughput screening of 16 million serologically negative blood donors for hepatitis B virus, hepatitis C virus and human immunodeficiency virus type-1 by nucleic acid amplification testing with specific and sensitive multiplex reagent in Japan. J Virol Methods, 112, 145–51.CrossRefGoogle Scholar
Minegishi, K., Yoshikawa, A., Kishimoto, S., et al. (2003) Superiority of minipool nucleic acid amplification technology for hepatitis B virus over chemiluminescence immunoassay for hepatitis B surface antigen screening. Vox Sang, 84, 287–91.CrossRefGoogle ScholarPubMed
Mosley, J. W., Stevens, C. E., Aach, R. D., et al. (1995) Donor screening for antibody to hepatitis B core antigen and hepatitis B virus infection in transfusion recipients. Transfusion, 35, 5–12.CrossRefGoogle ScholarPubMed
Niederhauser, C., Schneider, P., Fopp, M., et al. (2005) Incidence of viral markers and evaluation of the estimated risk in the Swiss blood donor population from 1996 to 2003. Euro Surveill, 10(2), 14–16.CrossRefGoogle ScholarPubMed
NIH Consensus Statement. Infectious Disease Testing for Blood Transfusions (1995) NIH, Office of the Director, Jan 9–11, 13(1), 1–29.
Offergeld, R., Faensen, D., Ritter, S., et al. (2005) Human immunodeficiency virus, hepatitis C and hepatitis B infections among blood donors in Germany 2000–2002: risk of virus transmission and the impact of nucleic acid amplification testing. Euro Surveill, 10(2), 8–11.CrossRefGoogle ScholarPubMed
Owusu-Ofori, S., Temple, J., Sarkodie, F., et al. (2005) Predonation screening of blood donors with rapid tests: implementation and efficacy of a novel approach to blood safety in resource-poor settings. Transfusion, 45, 133–40.CrossRefGoogle ScholarPubMed
Pereira, A. (2003) Health and economic impact of post-transfusion hepatitis B and cost-effectiveness analysis of expanded HBV testing protocols of blood donors: a study focused on the European Union. Transfusion, 43, 192–201.CrossRefGoogle Scholar
Pillonel, J., Laperche, S. and sang, L'Etablissement Francais du. (2005) Trends in risk of transfusion-transmitted viral infections (HIV, HCV, HBV) in France between 1992 and 2003 and impact of nucleic acid testing (NAT)Euro Surveill, 10(2), 5–8.CrossRefGoogle Scholar
Pillonel, J., Laperche, S., Saura, C., et al. (2002) Trends in residual risk of transfusion-transmitted viral infections in France between 1992–2000. Transfusion, 42, 980–88.CrossRefGoogle Scholar
Prince, A., Lee, D.-H. and Brotman, B. (2001) Infectivity of blood from PCR-positive, HBsAg-negative, anti-HBs positive cases of resolved hepatitis B infection. Transfusion, 41, 329–32.CrossRefGoogle ScholarPubMed
Rehermann, B., Ferrari, C., Pasquinelli, C., et al. (1996) The hepatitis B virus persists for decades after patients' recovery from acute viral hepatitis despite active maintenance of a cytotoxic T-lymphocyte response. Nat Med, 2, 1104–8.CrossRefGoogle ScholarPubMed
Roth, W. K., Weber, M., Petersen, D., et al. (2002) NAT for HBV and anti-HBc testing increase blood safety. Transfusion, 42, 869–75.CrossRefGoogle ScholarPubMed
Satake, M., Taira, R., Yugi, H., et al. (2005) Lookback study for transfusion-related HBV infection in Japan. Transfusion, 45(Suppl.), 9A (abstract).Google Scholar
Sato, S., Ohhashi, W., Ihara, H., et al. (2001) Comparison of the sensitivity of NAT using pooled donor samples for HBV and that of a serologic HBsAg assay. Transfusion, 41, 1107–13.CrossRefGoogle ScholarPubMed
Schreiber, G. B., Busch, M. P., Kleinman, S. H., et al. (1996) The risk of transfusion-transmitted viral infections. N Eng J Med, 334, 1685–90.CrossRefGoogle ScholarPubMed
Seed, C. R., Cheng, A., Ismay, S. L., et al. (2002) Assessing the accuracy of three viral risk models in predicting the outcome of implementing HIV and HCV NAT donor screening in Australia and the implications for future HBV NAT. Transfusion, 42, 1365–72.CrossRefGoogle ScholarPubMed
Serious Hazards of Transfusion Annual Report 2004 (2005), ISBN 0 9532 789 7 2, 21 November 2005, (available at: www.SHOT-uk.org).
Soldan, K., Barbara, J. A. J. and Dow, B. C. (2002) Transfusion-transmitted hepatitis B virus infection in the UK: a small and moving target. Vox Sang, 83, 305–8.CrossRefGoogle ScholarPubMed
Soldan, K., Barbara, J. A. J., Ramsay, M. E., et al. (2003) Estimation of the risk of hepatitis B virus, hepatitis C virus and human immunodeficiency virus infectious donations entering the blood supply in England, 1993–2001. Vox Sang, 84, 274–86.CrossRefGoogle Scholar
Soldan, K., Davison, K. and Dow, B. (2005) Estimates of the frequency of HBV, HCV and HIV infectious donations entering the blood supply in the United Kingdom, 1996 to 2003. Euro Surveill, 10(2), 17–9.CrossRefGoogle ScholarPubMed
Stramer, S., Brodsky, J., Preston, S., et al. (2001) Comparative sensitivities of HBsAg and HBV NAT. Transfusion, 41(Suppl.), 8S (abstract).Google Scholar
Stramer, S. L. (2005) Pooled hepatitis B virus DNA testing by nucleic acid amplification: implementation or not. Transfusion, 45, 1242–6.CrossRefGoogle ScholarPubMed
Stramer, S. L., Glynn, S. A., Kleinman, S. H., et al. (2004) Detection of HIV-1 and HCV infections among antibody-negative blood donors by nucleic acid-amplification testing. N Eng J Med, 351, 760–8.CrossRefGoogle ScholarPubMed
Wachs, M. E., Amend, W. J., Ascher, N. L., et al. (1995) The risk of transmission of hepatitis B from HBsAg(−), HBcAb(+), HBIgM(−) organ donors. Transplantation, 59, 230–4.CrossRefGoogle ScholarPubMed
Wang, J.-T., Lee, C.-Z., Chen, P.-J., et al. (2002) Transfusion-transmitted HBV infection in an endemic area: the necessity of more sensitive screening for HBV carriers. Transfusion, 42, 1592–7.CrossRefGoogle Scholar
Yoshikawa, A., Gotanda, Y., Itabashi, M., et al. and the Japanese Red Cross NAT Screening Research Group (2005) Hepatitis B NAT virus-positive blood donors in the early and late stages of HBV infection: analyses of the window period and kinetics of HBV DNA. Vox Sang, 88, 77–86.CrossRefGoogle Scholar
Yotsuyanagi, H., Yasuda, K., Moriya, K., et al. (2001) Frequent presence of HBV in the sera of HBsAg-negative, anti-HBc-positive blood donors. Transfusion, 41, 1093–9.CrossRefGoogle ScholarPubMed
Yugi, H., Hino, S., Satake, M., et al. (2005) Implementation of donor screening for infectious agents transmitted by blood by nucleic acid technology in Japan. Vox Sang, 89, 265.CrossRefGoogle ScholarPubMed
Yugi, H., Mizui, M., Tanaka, J., et al. (2006) Hepatitis B virus (HBV) screening strategy to ensure the safety of blood for transfusion through a combination of immunological testing and nucleic acid amplification testing – Japanese experience. J Clin Virol, 36(Suppl.), S56–S64.CrossRefGoogle ScholarPubMed
Zervou, E. K., Dalekos, G. N., Boumba, D. S., et al. (2001) Value of anti-HBc screening of blood donors for prevention of HBV infection: results of a 3-year prospective study in Northwestern Greece. Transfusion, 41, 652–8.CrossRefGoogle ScholarPubMed
Zuckerman, J. N. and Zuckerman, A. J. (2000) Current topics in hepatitis B. J Infect, 41, 130–6.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×