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Juhl D, Knobloch JK, Görg S, et al. Comparison of Two Test Strategies for Clarification of Reactive Results for Anti-HBc in Blood Donors. Transfus Med Hemother. 2015;43(1):37-43doi: 10.1159/000441676.
Juhl, D., Knobloch, J. K., Görg, S., & Hennig, H. (2016). Comparison of Two Test Strategies for Clarification of Reactive Results for Anti-HBc in Blood Donors. Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie, 43(1), 37-43. https://doi.org/10.1159/000441676
Juhl, David, et al. "Comparison of Two Test Strategies for Clarification of Reactive Results for Anti-HBc in Blood Donors." Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie vol. 43,1 (2016): 37-43. doi: https://doi.org/10.1159/000441676
Juhl D, Knobloch JK, Görg S, Hennig H. Comparison of Two Test Strategies for Clarification of Reactive Results for Anti-HBc in Blood Donors. Transfus Med Hemother. 2016 Jan;43(1):37-43. doi: 10.1159/000441676. Epub 2015 Nov 04. PMID: 27022321; PMCID: PMC4797462.
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Transfus Med Hemother. 2016 Jan;43(1):37-43. doi: 10.1159/000441676. Epub 2015 Nov 04.

Comparison of Two Test Strategies for Clarification of Reactive Results for Anti-HBc in Blood Donors.

Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie

David Juhl, Johannes K-M Knobloch, Siegfried Görg, Holger Hennig

Affiliations

  1. Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany.
  2. Institute of Medical Microbiology and Hygiene, University Hospital of Schleswig-Holstein, Lübeck, Germany.

PMID: 27022321 PMCID: PMC4797462 DOI: 10.1159/000441676

Abstract

OBJECTIVE: Testing for antibodies against hepatitis B core antigen (anti-HBc) was introduced to detect blood donors suffering from occult hepatitis B infection. Confirmation of specification of reactive results in the anti-HBc screening assay is still a challenge for blood donation services.

METHODS: Two different test strategies for confirmation of specification of reactive anti-HBc tests, one performed in our institute and one suggested by the German authority (Paul-Ehrlich-Institut (PEI)), were compared. The first strategy is based on one supplemental anti-HBc test, the other requires two supplemental anti-HBc tests.

RESULTS: 389 samples from 242 donors were considered. Both test strategies yielded concordant results in 117 reactive samples termed 'true-positive' or 'specificity confirmed', in 156 reactive samples termed 'false-positive' or 'specificity not confirmed', and in 99 negative samples. In 17 samples obtained from 11 donors, both test strategies gave discrepant results ('false-positive' but 'specificity confirmed'). In 10 of 11 donors, a real HBV infection was very unlikely, one remained unclear. 30 donors considered 'false-positive' became negative in all anti-HBc tests after follow-up testing and thus eligible for donor re-entry.

CONCLUSIONS: The test strategy suggested by the PEI yielded no additional information but induced an overestimation of HBV infections and unnecessary look-back procedures. Many anti-HBc-reactive donors can be regained after follow-up testing.

Keywords: Anti-HBc; Blood donor; Donor re-entry; HBV DNA; Hepatitis B virus

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