Prevalence of Hepatitis B Virus DNA Among Blood Donors in Nablus- West Bank

Background: Detection of Hepatitis B Virus (HBV) DNA without Hepatitis B surface Antigen (HBsAg) with or without the presence of HBV seropositive antibodies outside the window period defines occult HBV infection (OBI). Transmission of HBV from donors who were non-reactive for HBsAg and reactive for Hepatitis B core (anti-HBc) antibodies has been documented. Therefore the prevention of the residual risk of transfusion transmitted hepatitis B virus (HBV) could be minimized by testing blood, blood components, and organs of transplantation for antibodies against hepatitis B core antigen (anti-HBc) and or HBV-DNA. Objectives: The objectives of the present study were to investigate the: 1) prevalence of anti-HBc antibodies among Palestinian blood donors, 2) prevalence of HBV-DNA among anti-HBc positive blood donors in Nablus blood bank centers. Methods: Five hundred blood donors were selected by convenience sampling method from three blood donation centers in Nablus city. They were asked to fill out specially-designed questionnaires. Blood donors were classified into two groups based on the motive for donation, therapeutic and non-therapeutic. Therapeutic blood donations were excluded and discarded. Specimens from blood donors were screened for HBsAg, anti HCV, and anti-HIV 1 and 2 at the collection sites. Blood units that passed the routine screening tests were tested for anti-HBc antibodies by ELISA. Samples that were positive for anti-HBc antibodies were tested for the presence HBV-DNA using home-made real time polymerase chain reaction (RT-PCR). Results: A total of eleven (2.2%) donations were excluded from the study, 6 (1.2%) were therapeutic blood donations, 4(0.8%) were reactive to HBsAg, and 1(0.2%) was reactive to anti HCV. Forty nine (10%) of the remaining 489 blood specimens were reactive to anti-HBc antibodies. Forty five (92%) of them were positive for HBV DNA with an average of 13.5×10³ copies/ml. Conclusion: The prevalence of occult HBV among anti-HBc positive Palestinian blood donors was high. Therefore, introducing anti-HBc antibodies testing in the routine screening in blood bank centers will minimize the possibility of HBV transmission, taking into consideration the cost effectiveness of this test in comparison to the real time PCR.