Prospective Study Indicating That Double-Antibody Radioimmunoassay Reduces the Incidence of Post-Transfusion Hepatitis B

This prospective study comprising 227 recipients illustrates that post-transfusion hepatis B infection probably would have been reduced considerably if a double-antibody radioimmunoassay (RIA-DA) method had been used to screen donor bloods for hepatitis B antigen (HBs Ag). In seven susceptible recipients (negative for HBs Ag and antibody to HBsAg) who received RIA-DA-positive blood alone clinical hepatitis B subsequently developed, or there was serologic evidence of exposure to hepatitis B virus. In contrast, a recently licensed solid-phase RIA technic (Ausria-125I) of comparable sensitivity failed to implicate a positive donor for five of these recipients, including two in whom clinical hepatitis B developed. Our RIA-DA procedure may be detecting additional antigenic determinants unrelated to HBs Ag. Anti-HBs detected in recipients before transfusion appears to offer protection from post-transfusion infection by hepatitis B virus. (N Engl J Med 290:1104–1109, 1974)