1. Active or recovered hepatitis B infection

Must not donate

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

a) If:

• The history of HBV infection is not certain, and
• It is more than 12 months from recovery, and
• A test for Anti-HBc will be performed,

accept for donation or take samples for testing, as directed by local procedures.

b) If the donor has been tested previously by the Blood Transfusion Service and no new risks are disclosed, accept.

a) anti-HBc positive donors.
Must not donate

b) anti-HBc negative donors who reported hepatitis B infection. If:

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

accept.

SaBTO have recommended that all donors are tested at least once for anti-HBc, which is a marker of hepatitis B infection. Individuals who have recovered from hepatitis B will remain anti-HBc positive. There is a risk that reactivation of hepatitis B virus in such an individual could give rise to occult hepatitis B infection which is not detected by routine testing. For this reason, donors who are anti-HBc positive are deferred from donation.

SaBTO included in their recommendations a discretion that anti-HBc positive donors could be accepted if (1) they have adequate immunity to HBV, as demonstrated by an anti-HBs result of greater than 100 iu/l in a validated assay within 24 months of donation and (2) all of their donations will be tested by individual HBV DNA testing. UK Blood Transfusion Services are not currently implementing this approach. These guidelines will be revised should any service implement this additional testing at a future date.

It is likely that donors who are anti-HBc negative have not had hepatitis B in the past. They do not require any additional testing once the diagnosis of hepatitis B has been excluded.