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# Hepatitis B - Whole blood and components

## Essential information

Definition/s

  HBV: Hepatitis B virus

  HBsAg: Hepatitis B surface antigen

  Anti-HBs: Antibody against hepatitis B surface antigen

  Anti-HBc: Antibody against hepatitis B core antigen

  Active hepatitis B infection refers to an individual with circulating HBsAg and/or HBV DNA. This term includes acute and chronic hepatitis B infection.

  Recovered hepatitis B infection refers to an individual who was previously diagnosed with hepatitis B infection but has subsequently cleared HBV from their circulation.

  Current exposure refers to an individual who has recent household or sexual contact with an individual with active or recovered hepatitis B infection. 'Recent' is defined as the last 4 months for household contacts or the last 3 months for sexual contacts.

  Previous exposure refers to an individual who has been a household contact more than 4 months ago, or a sexual contact more than 3 months ago, of someone with active or recovered hepatitis B infection.

  The longer time period specified for household contact is a requirement of the Blood Safety and Quality Regulations (BSQR).

  Hepatitis B (HBV) testing, unless otherwise stated, refers to routine HBsAg and pooled HBV DNA (NAT) testing.

### Scenarios

Active or recovered HBV infection

Obligatory

  Must not donate.

  This includes donors who are identified as anti-HBc positive by Blood Transfusion Service testing.

Discretionary
  1. If:
     1. The history of HBV infection is not certain, and
     2. It is more than 12 months from recovery, and
     3. A test for anti-HBc will be performed, accept for donation or take samples for testing, as directed by local procedures, accept.
  2. If the donor has been tested previously by the Blood Transfusion Service and no new risks are disclosed, accept.
Additional information

  Post session review of results:

  1. anti-HBc positive donors:

  Must not donate.

  2. anti-HBc negative donors who reported hepatitis B infection.

  If:

  - It is more than 12 months from recovery, and
  - The donor is negative for all markers (HBsAg, screening HBV DNA and anti-HBc negative),

  accept.

Individuals with current exposure to someone with active HBV infection

Obligatory

  Must not donate.

Additional information

  Donors who have a sexual partner or household contact with active HBV infection may be at risk of acquiring HBV. Current guidelines do not allow a donor with a recent or ongoing risk of exposure to HBV to give blood, even if the donor is fully vaccinated against HBV.

Individuals with current exposure to someone with recovered HBV infection

Obligatory

  Must not donate.

Discretionary
  1. If:
     1. It is at least 3 months after a sexual partner recovered from hepatitis B, and
     2. It is at least 4 months after a household contact recovered from hepatitis B, and
     3. A test for anti-HBc will be performed,
        accept for donation or take samples for testing, as directed by local procedures.
  2. If the donor has been previously tested by the Blood Transfusion Service, and no new risk is disclosed, accept.
Additional information

  Post-session review of results:

  1. If the donor is negative for all hepatitis B markers, including anti-HBC, the donor can be accepted. Additional hepatitis B testing is not required for future donations unless the donor discloses a new risk.
  2. If any of HBsAg, anti-HBc or HBV DNA are positive, refer to Active or recovered HBV infection above.

  The risk of acquiring hepatitis B infection from someone who has recovered from hepatitis B is very low. Testing for anti-HBc will rule out the possibility that the donor picked up HBV at an earlier stage when their sexual or household contact may have been infectious.

  If the sexual or household contact has no history of hepatitis B but has been told they are anti-HBc positive, indicating previous infection only, it is likely that several months have elapsed since the contact cleared the virus from their circulation. The donor can be accepted for donation if anti-HBc testing will be undertaken on the donation, as long as their contact has not had an unexplained illness consistent with hepatitis B in the previous 3 months (sexual partner) or 4 months (household contact). There is no requirement to test the sexual partner or household contact.

Individuals with previous exposure to someone with active or recovered HBV infection

Obligatory

  Must not donate.

Discretionary
  1. If:
     1. It is at least 3 months since sexual contact, and
     2. It is at least 4 months since household contact, and
     3. A test for anti-HBc will be performed on the donation,
        accept for donation or take samples for testing, as directed by local procedures.
  2. If the donor has been tested previously by the Blood Transfusion Service and no new risks are disclosed, accept.
Additional information

  Post-session review of results:

  1. If the donor is negative for HBV and anti-HBc all hepatitis B markers, including anti-HBc, the donor can be accepted. Additional hepatitis B testing is not required for future donations unless the donor discloses a new risk.
  2. If any of HBsAg, anti-HBc or HBV DNA are positive, refer to Active or recovered HBV infection above.

Immunisation

Obligatory

  Known exposure:

  Must not donate.

  No known exposure:

  Must not donate.

Discretionary

  Known exposure:

  If it is more than 4 months from the date of exposure, samples can be taken for HBV and anti-HBc testing. No donation should be taken.

  No known exposure:

  If it is more than 14 days from the date of the most recent dose of vaccine, accept.

See if relevant

  Hepatitis A (immunisation)

  Immunoglobulin therapy

Additional information

  Post-session review of results:

  1. If the donor is negative for HBV and anti-HBc, the donor can be accepted. Additional hepatitis B testing is not required for future donations unless the donor discloses a new risk.
  2. If any of HBsAg, anti-HBc or HBV DNA are positive, refer to Active or recovered HBV infection above.

  Specific HBV immunoglobulin may be used in the management of individuals who have been exposed to hepatitis B.
  Administration of hepatitis B vaccine can lead to low level reactivity in HBsAg screening assays. For this reason, donors must be deferred until at least 14 days after receiving a dose of vaccine, even if they have not been exposed to HBV.
  Hepatitis B vaccine is sometimes given in a combined vaccine with hepatitis A vaccine.

Reason for change:
  The deferral after HBV immunisation has been increased.
Version details:

  WB-DSG Edition 203 Release 87 (28 August 2025)

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