Detection of hepatitis B virus DNA in donor blood by the polymerase chain reaction.

ABSTRACT

BACKGROUND. Blood collected from voluntary donors at local blood banks and blood donation camps was screened for the hepatitis B virus genome using the polymerase chain reaction and for viral markers by standard serological techniques. The sensitivities of the two screening strategies were compared. METHODS. One hundred and twenty-six blood samples were tested for HBV serological markers--HBsAg, anti-Hbs and anti-HBc--by ELISA. The same samples were also subjected to the polymerase chain reaction using primers made by us. RESULTS. Analysis of the polymerase chain reaction amplified products revealed that 24% of the blood samples which tested negative for HBsAg using the ELISA technique were positive for HBV DNA by the polymerase chain reaction. All the HBsAg positive samples (by ELISA) were also positive by the polymerase chain reaction (which detected additional samples as well). Anti-HBc antibodies showed a much greater concordance with the polymerase chain reaction. CONCLUSIONS. The results emphasize that the screening strategies for donor blood need to be re-evaluated in order to check inadvertent transmission of hepatitis B virus during blood transfusion. The ELISA technique to detect HBsAg as the sole serological marker is inadequate to indicate the actual prevalence of hepatitis B virus in the donor blood. The polymerase chain reaction may be a better screening test. If this is not available, the detection of anti-HBc antibodies appear to be a better means of screening blood than HBsAg.