The anti-HB core (HBc) total antibody titer was evaluated using MONOLISA ELISA (Biorad) kits
The anti-HB core (HBc) total antibody titer was evaluated using MONOLISA ELISA (Biorad) kits. were also found out by enzyme-linked fluorescent assay (ELFA). Materials and Methods ?A total of 910 serum samples was subjected to initial screening for HBsAg by MERILISA HBsAg ELISA kits. The anti-HB core (HBc) total antibody titer was evaluated using MONOLISA ELISA (Biorad) kits. If found negative, the samples were discarded. If found positive, the samples underwent HBV DNA testing by nested PCR. Antibody to hepatitis B surface antigen (anti-HBs) was calculated among the DNA positives by ELFA. Results ?A total of 133 samples were positive for anti-HBC total antibody, resulting in an overall R112 prevalence of 14.6%. Overall prevalence of HBV DNA among the anti-HBc seropositives was 2.2%. Conclusion ?Among the three HBV DNA positive patients, two belonged to the preoperative screening group, which is an alarming situation. Screening of blood for HBsAg has reduced the incidence of posttransfusion hepatitis, but HBV still remains the major source of transfusion transmitted infection in India. strong class=”kwd-title” Keywords: Anti-hepatitis B core total antibody, HBV DNA, Occult hepatitis B Introduction Hepatitis B virus (HBV) infection is an endemic in many Asian countries, but highly effective vaccination programs in some countries have shifted this pattern toward intermediate or low endemicity. India falls in an intermediate endemic zone (prevalence of 2C7%, with an average of 4%), with a disease burden of approximately 50 million. 1 Blood transfusion and unsafe therapeutic injections continue to be important modes of transmission of HBV. For several decades, laboratories have relied on serological screening of patients using sensitive HBsAg assays to detect HBV infection. Some countries have also adopted anti-HB core (HBc) assays to detect chronic carriers with low-level viremia and who lack detectable HBsAg. 2 Despite the screening methods, it was observed that HBV infection can still occur even in the absence of HBsAg, which is known as occult HBV infection (OBI). 3 This phenomenon is becoming increasingly recognized in several clinical settings worldwide. OBI is simply defined as presence of circulating HBV DNA among those with serologically undetectable hepatitis B surface R112 antigen (HBsAg) negatives. OBI may be antibody (anti-HBc alone or together with anti-HBs) positive (seropositive OBI), or antibody negative (seronegative OBI). 4 The Taormina Consensus Conference in 2008 further defined OBI as the presence of HBV DNA in the liver of individuals testing HBsAg negative Rabbit polyclonal to ADAM5 with currently available R112 assays and introduced a cutoff value for serum HBV DNA ( 200 IU/mL). 5 Studies on a large set of blood donors using NAT (nucleic acid testing) confirmed this phenomenon of OBI and formed the basis of mandatory NAT for transfused blood units in many developed countries. Such a testing algorithm is still not incorporated in many laboratories in developing countries including India. 6 7 OBI can cause fulminant hepatitis. It is associated with development of hepatocellular carcinoma and cryptogenic liver disease. It can also affect the disease progression of chronic hepatitis C virus (HCV) patients. 8 9 In India, HBV infection is diagnosed by detection of HBsAg. Detection of anti-HBc antibody is rarely done as it is not mandatory. 10 In India, blood reactive for anti-HBc can be transfused to patients. In India, it is recommended that blood with high anti-HBc titer are rejected, but titer is not defined. 11 Patients with occult HBV infection, who lack detectable HBsAg with anti-HBc positivity and HBV DNA, are a potential source of HBV infection. 12 HBV can also be transmitted when liver is transplanted R112 from a HBsAg negative, anti-HBc positive patient, which proves that liver harbors infectious HBV in some patients negative for HBsAg but positive for anti-HBc. 13 OBI carriers with high anti-HBs levels are unlikely to transmit the infection, whereas those with anti-HBc only might transmit the infection. 14 The aim of this study was to detect the prevalence of anti-HBc total antibody among the HBsAg negative individuals by enzyme-linked immunosorbent assay (ELISA), and detect the presence of HBV DNA among the anti-HBc seropositives by polymerase chain reaction (PCR). Anti-HBs among the HBV DNA positives were also found out by enzyme-linked fluorescent assay (ELFA). Materials and Methods This study was conducted from January 2018 to December 2018 and the proposal for the study was approved by the Ethical Committee of Government TD Medical College. Serum samples were collected from patients who were more R112 than 18 years old belonging to the following groups after obtaining informed consent: preoperative screening patients ( em n /em = 517), human immunodeficiency virus (HIV) positives ( em n /em = 223), patients on hemodialysis ( em n /em = 108), HCV positives ( em n /em .