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Bangladesh Medical Journal 2012 Vol. 41 No.3

Original Article

September 2012 Issue

AntiHBc (total) As a Screening Assay for Safety of Donated Blood.

M Z Rahman», M R Alam-, S Parveen-‘,D S Ahmed», M A Rahman ‘, M S Chowdhury», M A Rana», H Masud8

Abstract:

Detection of hepatitis B surface antigen (HBsAg) in blood

is diagnostic for hepatitis B virus (HBV) infection.In blood

bank, screening for HBsAg is carried out routinely to

detect HBV infection. Despite this, transfusion-associated

HBV infection still occurs due to presence of occult HBV

infection. The aim of this study was to detection of occult

HBV infection among the HBsAg negative/ Anti-HBc(total)

positive donar.A total of 52 patients negative for HBsAg,

but positive for Anti HBc(total) were included in this

study. All the patients were then investigated for

determination of Anti-HBs titre and HBV-DNA (PCR).Out

of 52 patients, HB V DNA was detected in 16

patients(8.32%). Overall, 18 patients (9.36%) out of 52

were found positive for AntiHBs antibody. Among antiHBs

positive patients, who are supposedly protected against

HBV infection,

6

(33.33%)patients had detectable

HBVDNA.ln conclusion,a considerable number of HBV

infected donars remain undiagnosed,

if

only HBsAg is used

for screening.Addition of AntiHBc(total) testing for donar

screening will definitely eliminate HB V infected blood

donations and help in reducing HBV transmission with its

potential consequences.

Introduction:

Transmission of hepatitis B virus (HBV) infection through

donated blood is a common occurrence. In blood bank,

screening for HEsAg is carried out routinely to detect HBV

infection.Despite testing for HBsAg in blood donars,

transfusion-associated HEV infection continue to be a

major problems in Bangladesh.

Several reasons may account for the inability to entirely

1. Dr. Md. Zahidur Rahman, Assistant Profes or, Department

of Gastroenterology, BSMMU, Shahabag, Dhaka.

2. Dr. Md Razibul Alam, Assistant Professor, Department

of Gastroenterology, BSMMU, Shahabag, Dhaka.

3. Dr. Shohely Parveen, Medical officer, Department of

Paediatrics, BSMMU, Shahabag, Dhaka.

4. Dr. Dewan Saifuddin Ahmed, Associate Professor,

Department of Gastroenterology, BSMMU, Shahabag, Dhaka.

5. Dr. Mohammad Asadur Rahman, Medical officer,

Department of Gastroenterology, BSMMU, Shahabag, Dhaka.

6. Dr.Mohammad Shoaib Chowdhury, Medical officer,

Department of Gastroenterology, BSMMU, Shahabag, Dhaka.

7. Dr. Mushtaque Ahmad Rana, Resident Gastroenterology,

BSMMU, Shahabag, Dhaka.

8. Dr. Hasan Masud, Associate Professor, Department of

Gastroenterology,BSMMU,

Shahabag,

Dhaka.

Corresponding Authores: Dr. Md. Zahidur Rahman, Assistant

Professor,Departmentof Gastroenterology,BSMMU,Shahabag,Dhaka.

42

eliminate that risk.! HBsAg tests may be negative in the

window phase of acute HBV infection, as well as in

chronic HBV infections with very low levels of HBsAg. In

addition, mutant forms of HEV due to either single or

multiple mutations of the «a» determinant of HBsAg may

escape detection by the currently available HBsAg

screening assays, and the safety of blood supply can then

be affected.s-‘

Detection of potentially infectious HBVDNA in the liver,

serum or both, in individuals without detectable HEsAg in

circulation has been termed occult HBV infection.f High

frequencies of HBVD A positivity have been described

among antiHBc positive individuals, when antiHBc is the

only seromarkers for HBV infection, in the absence of

antiHBs or HBsAg5,6.

Antibodies to hepatitis B core (HBc) antigen are marker of

acute, chronic, or resolved HEV infection and remain

detectable for life. These can be present in the absence of

both HBsAg and anti-HBs antibodies. Anti-HBc is

therefore detected in anyone who has been infected with

hepatitis B virus.’

It has been demonstrated that some HbsAg negative

individuals and those positives for anti-HBc continue to

replicate hepatitis B virus (HBV).7,8 These findings

suggest that recovery from acute hepatitis B virus infection

may not result in complete virus elimination, but rather the

immune system keeps the virus at a very low level. A

positive correlation has been shown between anti-HBc titre

and detection of HE -D A in serum samples of HBsAg

negative individual.?

In this study, we wanted to find out the rate of HBVDNA

detection in HBsAg-ve, antiHBc positive donations. Since

Anti-HEc detection can completely eliminate the risk of

HEV transrnis ion and it is not done in all the center of

Bangladesh. we propo ed whether Anti-HBc(total) could

be adopted as a creening assay for the donated blood.

Matertals

and

Methods:

Thi ob ervarional tudy was carried out in the department

of Gastroenterology.Bangabandhu Sheikh Mujib medical

university, Dhaka and period of study was from July 2010

tojuly2012.

A total of 52 patients (41 male, 11 female, mean age

30±9.3) positive for AntiHBc(total), but negative for

HBsAg ( whose blood is rejected for transfusion in blood

bank ) came to our department for evaluation.All the

patients were tested for AntiHBs antibody and

HBVDNA(PCR).

Results:

Overall, 18 patients (9.36%) out of 52 were found positive

for AntiHBs antibody (Table 1). Among the 18 patients

with positive AntiHBs antibody, 12 patients had antibody



Источник: www.researchgate.net


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