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764) A 41-year-old healthy man donated blood at a local Red Cross. A week later, he received a blood screening test report indicating his hepatitis B core antibody (HBcAb) test was positive. He was referred to a liver disease specialist for additional evaluation. Additional test results showed that the patient was hepatitis B surface antigen (HBsAg) negative, hepatitis B surface antibody (HBsAb) positive, and hepatitis anti-core IgM negative. Which one of the following statements best describes the man’s current status with regard to hepatitis B virus (HBV)?

Acute HBV infection. Immune to HBV due to natural infection. Immune to HBV due to HBV vaccination. Chronic HBV infection. Susceptible to HBV infection.

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• Hepatitis B virus (HBV) serologic testing involves the measurement of several HBV-specific antigens and antibodies.

• The combinations of different serologic markers are used to identify different phases of HBV infection and to determine whether a patient has acute or chronic HBV infection, is immune to HBV as a result of prior infection or vaccination, or is susceptible to HBV infection.

• All volunteer blood donors are screened for HBV exposure using a hepatitis B core antibody (HBcAb) EIA, hepatitis B surface antigen (HBsAg) testing, and, at some blood centers, HBV nucleic acid testing.

• The presence of both hepatitis B surface antibody (HBsAb) and HBcAb indicates previous infection with HBV in an undefined time frame.

• The risk of acquiring HBV infection through blood transfusion currently ranges between 1:200,000 and 1:500,000.

Zou S, et al: Current Incidence and residual risk of hepatitis B infection among blood donors in the United States. Transfusion 2009;49:1609-1620.

Stramer S: Current risks of transfusion-transmitted agents: a review. Arch Pathol Lab Med 2007;131:702-707.

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Clinical Pathology: Microbiology, Virology

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