The value of screening blood donors for antibody to hepatitis B core antigen.

Rapid counter-immunoelectrophoresis (CIE) and radioimmunoassay (RIA) methods for detecting antibody to hepatitis B core antigen (anti-HBc) were used to screen nearly 8000 blood donors, including 919 prisoners. The prevalence of anti-HBc in prisoner donors (3.4%) was significantly higher than that in other donors (0.7%). The three HBsAg positive donors in the series were all anti-HBc positive and, of the other 73 anti-HBc positive donors, 62 had antibody to HBsAg (anti-HBs). Two panels of control sera, including 155 HBsAg positive samples, were tested by CIE for anti-HBc: 149 of the 155 were anti-HBc positive. Of the six negative samples, four were HBsAg positive only by RIA. One of the panels, containing 16 weakly HBsAg positive samples, was available for anti-HBc testing by RIA. Fifteen of the samples were positive and the other was slightly reactive. Donor sera that gave unconfirmable reactions in initial CIE tests were invariably negative when tested by RIA. The RIA was a more sensitive and specific test for anti-HBc than CIE. The ways in which anti-HBc screening could meet the needs of blood transfusion centres are discussed. We suggest that, in areas of low prevalence, it has a role as a rapid confirmatory test of HBV infection and as a means of identifying those potentially infectious donations in which HBsAg cannot be detected.