Hepatitis B Virus DNA is Absent in Lebanese Blood Donors Who Are Positive for Both Anti-Hbc and Anti-Hbs Antibodies

Background A major risk during blood transfusion is the transmission of infectious agents such as Hepatitis B virus (HBV). Screening for anti-HBc antibodies has long been used to test HBV infection and thus, blood safety. However, the development of advanced tools enabling HBV-DNA detection rendered the diagnostic benefit of anti-HBc test uncertain. Objectives In this study, we aimed to evaluate the relationship between HBV-DNA, anti-HBs, and anti-HBc loads. Methods Sera of 7200 blood donors were first screened for HBs antigen (HBsAg) and anti-HBc antibody. Samples that were found to be HBsAg-negative but anti-HBc-positive were further tested for anti-HBs and HBV-DNA. Results Of the 7200 tested samples, 7143 (99.2%) were HBsAg-negative, while the remaining 57 (0.8%) samples were HBsAg-positive. Among the HBsAg-negative samples, 490 (6.8%) were anti-HBc-positive. Of the anti-HBc positive samples, 397 (81%) were anti-HBs-positive, while the remaining 93 (19%) samples were anti-HBs-negative. Interestingly, all of the anti-HBc positive samples, which also were positive for anti-HBs, exhibited negative HBV-DNA results. On the other hand, the anti-HBc positive samples, which were negative for anti-HBs, showed both negative and positive HBV-DNA results. Conclusions Blood samples which are positive for both anti-HBc and anti-HBs are characterized by negative HBV load.