Antibodies to hepatitis B core antigen in blood donors screened for alanine aminotransferase level and hepatitis non-A, non-B in recipients.

Four-hundred and seventeen patients undergoing open-heart surgery were followed for more than 9 months after transfusion. All 2270 blood units transfused had alanine aminotransferase levels less than or equal to 30 U/l. Blood units positive for antibodies to hepatitis B core antigen (anti-HBc) were more frequently associated with recipient hepatitis non-A, non-B (HNANB) (13.7%) than anti-HBc-negative units (4.2%) (p less than 0.001). The frequency of HNANB among recipients of at least 1 anti-HBc-positive blood unit (8/79, 10.1%) was fivefold greater than among recipients of exclusively anti-HBc-negative blood units (7/338, 2.1%) (p less than 0.01). In this study the exclusion of donors positive for anti-HBc (4.2%) might have reduced the incidence of recipient HNANB by 42 percent. These results support the introduction of anti-HBc donor screening to prevent recipient HNANB.