Anti-HBc and HBV-DNA among Blood Donors in North Africa; Western Libya

Background: Post transfusion hepatitis B (PTHB) continues to be an important public health concern with regard to blood transfusion in Libya and in Africa. This concern is related to the screening test which is still used but it is not enough to detect infective cases during window period.

Objectives: To determine the presence of total anti-HBc (hepatitis B core antibodies) and HBV-DNA (hepatitis B viral DNA (in healthy HBsAg (hepatitis B surface antigen) negative blood donors in Tripoli-Libya, North Africa.

Methods: A total of 1256 HBsAg negative blood samples, obtained from healthy blood donors who attended Tripoli’s central blood bank, were tested for anti-HBc using the VITROS® 3600 Immunodiagnostic System. The reactive samples were further tested for the presence of HBV-DNA.

Results: From the sample of 1256, 123 (10%) were total anti-HBc positive. Of the 123 anti-HBc positive samples, 13 (10.5%) tested positive for HBV-DNA by PCR (Polymerase chain reaction). The frequency of anti-HBc positive cases among the voluntary donors was 59.2%, and among the replacement donors was 40.7% (p<0.0001). The number of anti-HBc positive samples was found to be particularly high in the age group 30-39 years 44).7%) (p<0.0001).

All the positive PCR samples were from the age groups 20-39 and 40-59 with highest prevalence among 20-29 (p<0.0001). Most occupation who had positivity with anti-HBc and HBV-DNA were civil governmental workers specially militants, free workers and was less in students. Most positive cases were from east of Tripoli the capital (Tagora, SoqAljomaha).

Conclusion: The frequency of anti-HBc among this sample was 10% which is high compared with the international findings. The current study estimated the expected exclusion rate of anti-HBc positive donated blood, as this would be an important factor to consider before adopting anti-HBc testing in addition to HBsAg testing as a mandatory screening test to further enhance transfusion safety.