Anti-HBc testing for blood donations in areas with intermediate hepatitis B endemicity

Preventing hepatitis B virus and other transfusiontransmitted infectious diseases relies on stringent blood-donor qualifications and on serological screening for infectious disease markers among potential donors. Several studies have evaluated the reduced risk of transfusion-transmitted infections that comes from screening for hepatitis B core antibody (anti-HBc) in addition to testing for hepatitis B surface antigen (HBsAg), using the currently available serologic tests (1-7) or the newly developed molecular biology assays (8-10). However, most of these analyses were based on data from regions with low hepatitis B endemicity and/or from blood banks from developed countries, where repeat donors account for the majority of the blood supply. In South America, screening for hepatitis B surface antigen (HBsAg) is mandatory (11-13). Brazil, Venezuela, and Ecuador have also introduced anti-HBc testing in recent years (11, 14).