Detection Rate of Hepatitis B Virus DNA among Blood Donors showing HBsAg Positivity or Negativity and relatedness with other hepatitis B viral markers

Oh, Heung Bum; Cho, Youn Jung; Hwang, Yoo Sung; Kim, Doo Sung; Kim, Sang In

Abstract

BACKGROUND
Serologic assay for the detection of hepatitis B virus (HBV) surface antigen (HBsAg) have been used routinely in the screening of blood donors in Korea since 1973. However some investigators have reported the presence of HBV DNA in HBsAg negative blood. So this study is designed to determine the detection rate of HBV DNA according to various patterns of HBV markers in Korean blood donors.
METHODS
The presence of HBV DNA in plasma from 469 donors was determined by polymerase chain reaction using commercial kit (Bioneer HBV Detection Kit, Bioneer Corp., Chungbuk, Korea). 289 donors showing all negative results by donor screening tests and 120 donors showing positive results only in HBsAg test and 60 donors showing abnormal result only in alanine aminotransferase (ALT) test (> or =65 IU/L) were included in this study. Other markers for HBV infection such as anti-HBsAb, anti-HBcAb, HBeAg were also tested.
RESULTS
65 (54%) of 120 donors with positive for HBsAg and 5 (1.7%) of 289 donors without abnormal results in screening tests and 3 (5.0%) of 60 donors with elevated ALT were found to have HBV DNA in their plasma. Among 54 cases showing HBsAg-positive/HBeAg-positive, 52 cases (96%) were found to have HBV DNA. HBV markers in 5 cases showing HBsAg-negative/HBV DNA-positive were as follows: 2 (1.3%) among 159 cases showing anti-HBs-positive/anti-HBc-negative and 1 (20%) among 5 cases showing anti-HBs-negative/anti-HBc-positive and 1 (1.8%) among 55 cases showing anti-HBs-positive/anti-HBc-positive and 1 (1.5%) among 65 cases showing no viral markers. 3 cases with HBV DNA among elevated ALT groups were positive only in anti-HBs test.
CONCLUSION
This study indicates that serological markers for HBV infection are insufficient to guarantee the safety of donated blood. To improve the safety, it may be suggested that (1) donors with history of viral hepatitis or with history of HBsAg positivity shoud be indefinitely deferred from donation, (2) blood collected from donors who have showed HBsAg positive result at previous donation shoud be discarded, (3) HBsAg-negative /anti-HBs-negative /anti-HBc-positive blood should be discarded, (4) ALT screening should be continuously done because it could screen out HBsAg-negative /HBV DNA-positive blood irrespective of anti-HBc result, (5) HBV detction kit that can also detect HBV mutant shoud be developed, (6) governmental support for HBV vaccination program shoud be done especially for recruits.