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Impact of a policy to permit the return of donors repeat-reactive to the Abbott PRISM antibody to hepatitis B core antigen assay.

Abstract：

BACKGROUND:The expected donor loss from recent implementation of antibody to hepatitis B core antigen (anti-HBc) testing in Canada was uncertain but potentially significant based on US experience. To reduce donor loss from false-reactive tests, repeat-reactive donors without other evidence of infection were eligible to return. The aim was to evaluate the impact of anti-HBc testing on donor loss and to evaluate the effectiveness of this policy. STUDY DESIGN AND METHODS:For each donor in the first year of implementation (April 9, 2005-April 8, 2006) repeat-reactive for the presence of anti-HBc only but eligible to return (screening test for hepatitis B surface antigen-negative, plus not reactive to antibody to hepatitis B surface antigen [anti-HBs] and hepatitis B virus [HBV] DNA supplemental tests), 10 matched donors not reactive to the anti-HBc assay were selected. Return rates over 2 years were compared using conditional logistic regression. Testing outcomes were tabulated. RESULTS:Over the first year of testing, 412,236 donors (951,423 donations) were tested for anti-HBc, and 4,489 donors were repeat-reactive (1.3% of first-time donors, 1.0% of repeat donors). Of these 85.6 percent were also reactive for the presence of anti-HBs and/or HBV DNA supplemental tests leaving less than 15 percent eligible to return, of whom 73 percent returned (vs. 90% of controls, p < 0.001). Of the 300 anti-HBc repeat-reactive returning donors, 74 percent were anti-HBc repeat-reactive again (thus permanently deferred), 19 percent were deferred for other reasons versus 14 percent of controls (p < 0.05), and 7 percent (21 donors) did not react and were eligible to continue donating. CONCLUSION:Most donors repeat-reactive for the presence of anti-HBc likely have past exposure to HBV. If eligible, most are willing to return, but likely to test anti-HBc repeat-reactive again.

journal_name

Transfusion

journal_title

Transfusion

authors

O'Brien SF,Yi QL,Fan W,Fearon MA,Scalia V,Goldman M

doi

10.1111/j.1537-2995.2008.01973.x

subject

Has Abstract

pub_date

2009-02-01 00:00:00

pages

271-7

issue

eissn

0041-1132

issn

1537-2995

pii

TRF01973

journal_volume

pub_type

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Impact of a policy to permit the return of donors repeat-reactive to the Abbott PRISM antibody to hepatitis B core antigen assay.