JPAC Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee

Hepatitis B

1. Person with current hepatitis B infection
ObligatoryMust not donate.
2. Person with previous (recovered) hepatitis B infection
ObligatoryMust not donate.
DiscretionaryIf more than 12 months from recovery, and either
all markers i.e. HBsAg, HBVDNA if carried out and HB core antibody (anti-HBs is not required) are negative or,
if HB core antibody positive: HBsAg negative, screening HBV DNA (if carried out) negative and anti-HBs has been documented at more than 100 iu/l at some time, i.e. natural immunity, accept.
See if RelevantBlood Safety Entry
Additional InformationHepatitis B is a serious viral infection that can lead to chronic liver disease and liver cancer (hepatoma).

Individuals who are chronically infected are sometimes referred to as 'carriers'. They often have no, or minimal, symptoms associated with their infection.

Cases are often linked to place of birth, or mother s place of birth. The condition is very common in many parts of the world and vertical spread from mother to baby is often a major route of transmission. Hepatitis B may also be acquired by injecting drug use, sexual transmission and more rarely tattoos and piercings.

Leaving 12 months from recovery before testing provides additional security that the results will show if the infection is controlled and therefore unlikely to be passed on. There is no requirement to monitor the anti -HBs level, but if the donor is HB core antibody positive, anti-HBs must have been documented at >100iu/l at some point.
Reason for change'Person with current hepatitis B infection' and 'History of past Infection' have been separated.

'Known Carriers' has been removed as these individuals are 'Infected'. The term 'Carrier' may cause confusion.
3. Current or Former Sexual Partner of person with hepatitis B infection at time of last sexual contact with potential donor
ObligatoryMust not donate if less than 12 months from last contact
DiscretionaryObtain history (including time since last contact) and:

a) If still a partner or it is less than 12 months since the relationship ceased: If HB core antibody positive, HBsAg negative, screening HBV NAT (if carried out) negative and anti-HBs has been documented at more than 100 iu/l at some time, accept. Donor has natural immunity to hepatitis B

b) If more than 12 months since the relationship ceased and either all markers i.e. HBsAg, HBVDNA if carried out and HB core antibody (anti-HBs is not required) are negative,
or
if HB core antibody positive, HBsAg negative, screening HBV NAT (if carried out) negative and anti-HBs has been documented at more than 100 iu/l at some time, accept. No evidence of current infection, with or without immunity to hepatitis B.
Additional InformationThere is no requirement to monitor the anti-HBs level. Any further exposure to HBV would be expected to boost the anti-HBs level and provide protection against HBV. If negative for anti-HBc, there is no requirement for an anti-HBs result.
InformationThis entry is compliant with the Blood Safety and Quality Regulations 2005.
Reason for changeThe 'Discretionary' entry has been modified to allow former sexual partners of infected individuals to be accepted before 12 months have passed since the last sexual contact if they are naturally immune.
4. Current or former sexual partner of person who had recovered from hepatitis B infection at time of last sexual contact
ObligatoryMust not donate if less than 12 months from last contact
DiscretionaryObtain history (including date that the partner cleared the HBV infection and the date that HBV immunisation of the donor commenced) and:

If more than 12 months from date that the partner was stated to have recovered from / cleared HBV, or more than 12 months from the date that the donor received the first dose of a course of HBV vaccine, whichever is the later date, and either
all markers i.e. HBsAg, HBVDNA if carried out and HB core antibody (anti-HBs is not required) are negative,
or
HB core antibody positive, HBsAg negative, screening HBV DNA (if carried out) negative and anti-HBs has been documented at more than 100 iu/l at some time, accept.
Additional InformationThe current partner of an individual with hepatitis B infection should have been offered immunisation. If the relationship started after the diagnosis of hepatitis B, immunisation may not have been carried out.

There is no requirement to monitor the anti-HBs level. Any further exposure to HBV would be expected to boost the anti-HBs level and provide protection against HBV. If negative for anti-HBc, there is no requirement for an anti-HBs result.
InformationThis entry is compliant with the Blood Safety and Quality Regulations 2005.
Reason for changeNew additional guidance to cover donors who are the partners of people who have recovered from hepatitis B infection.
5. Person Currently or Formerly Sharing a Home with a person with hepatitis B infection at time when last shared a home
ObligatoryMust not donate if less than 12 months since sharing ceased.
DiscretionaryObtain history (if no longer sharing include the time since sharing ceased) and:

a) If still sharing or it is less than 12 months since sharing ceased:
If HB core antibody positive, HBsAg negative, screening HBV NAT (if carried out) negative and anti-HBs has been documented at more than 100 iu/l at some time, donor has natural immunity, accept.

b) If more than 12 months since sharing ceased and either all markers i.e HBsAg, HBVDNA if carried out and HB core antibody (anti-HBs is not required) are negative,
or
HB core antibody positive, HBsAg negative, screening HBV NAT (if carried out) negative and anti-HBs has been documented at more than 100 iu/l at some time, accept.
See if RelevantHepatitis B - 4. Immunization, below.
Additional InformationThere is no requirement to monitor the anti-HBs level. Any further exposure to HBV would be expected to boost the anti-HBs level and provide protection against HBV. If negative for anti-HBc, there is no requirement for an anti-HBs result.
InformationThis entry is compliant with the Blood Safety and Quality Regulations 2005.
Reason for changeThere has been a modification to 'Discretionary' and to 'Additional Information'.
6. Immunization
Obligatorya) Known Exposure:
Must not donate.


b) No Known Exposure:
Must not donate if:

Less than seven days after the last immunization was given.
Discretionarya) Known Exposure:
If more than 12 months from immunization, and either all markers i.e. HBsAg, HBVDNA if carried out and HB core antibody (anti-HBs is not required) are negative or
HB core antibody positive, HBsAg negative, screening HBV DNA (if carried out) negative and anti-HBs has been documented at more than 100 iu/l at some time, accept.

b) No Known Exposure:
If more than seven days after the last immunization was given, even after intramuscular immunoglobulin, accept.
See if RelevantHepatitis A - 4. Immunization
Additional InformationImmunization post exposure may be with specific anti-HB immunoglobulin as well as with HBsAg. Generally immunoglobulin would only be given after a known exposure to hepatitis B.

There is no requirement to monitor the anti-HBs level.

May be combined with hepatitis A immunization.

Sensitive assays for HBsAg may be positive following recent immunization. This is why a seven day deferral is required.
Update InformationThis entry was last updated in:
DSG-WB Edition 203, Release 18.
Reason for changeThe entry has been changed to improve clarity.
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