Hepatitis B

Must not donate

This includes donors who are identified as anti-HBc positive by Blood Transfusion Service testing.

a) If:

• The history of HBV infection is not certain, and
• It is more than 12 months from recovery, and
• A test for Anti-HBc will be performed,

accept for donation or take samples for testing, as directed by local procedures.

b) If the donor has been tested previously by the Blood Transfusion Service and no new risks are disclosed, accept.

a) anti-HBc positive donors.
Must not donate

b) anti-HBc negative donors who reported hepatitis B infection. If:

• more than 12 months from recovery, and
• The donor is negative for all markers (HBsAg, screening HBV DNA and anti-HBc negative)

accept.

SaBTO have recommended that all donors are tested at least once for anti-HBc, which is a marker of hepatitis B infection. Individuals who have recovered from hepatitis B will remain anti-HBc positive. There is a risk that reactivation of hepatitis B virus in such an individual could give rise to occult hepatitis B infection which is not detected by routine testing. For this reason, donors who are anti-HBc positive are deferred from donation.

SaBTO included in their recommendations a discretion that anti-HBc positive donors could be accepted if (1) they have adequate immunity to HBV, as demonstrated by an anti-HBs result of greater than 100 iu/l in a validated assay within 24 months of donation and (2) all of their donations will be tested by individual HBV DNA testing. UK Blood Transfusion Services are not currently implementing this approach. These guidelines will be revised should any service implement this additional testing at a future date.

It is likely that donors who are anti-HBc negative have not had hepatitis B in the past. They do not require any additional testing once the diagnosis of hepatitis B has been excluded.

Must not donate.

Donors who have a sexual partner or household contact with active HBV infection may be at risk of acquiring HBV. Current guidelines do not allow a donor with a recent or ongoing risk of exposure to HBV to give blood, even if the donor is fully vaccinated against HBV.

Must not donate

a) If:

• it is at least 3 months after a sexual partner recovered from hepatitis B, and
• it is at least 4 months after a household contact recovered from hepatitis B, and
• a test for Anti-HBc will be performed,

accept for donation or take samples for testing, as directed by local procedures.

b) If the donor has been previously tested by the Blood Transfusion Service, and no new risk is disclosed, accept.

a) If the donor is negative for all hepatitis B markers, including anti-HBC, the donor can be accepted. Additional hepatitis B testing is not required for future donations unless the donor discloses a new risk.

b) If any of HBsAg, anti-HBc or HBV DNA are positive, refer to Section 1: Active or recovered hepatitis B infection.

The risk of acquiring hepatitis B infection from someone who has recovered from hepatitis B is very low. Testing for anti-HBc will rule out the possibility that the donor picked up HBV at an earlier stage when their sexual or household contact may have been infectious.

If the sexual or household contact has no history of hepatitis B but has been told they are anti-HBc positive, indicating previous infection only, it is likely that several months have elapsed since the contact cleared the virus from their circulation. The donor can be accepted for donation if anti-HBc testing will be undertaken on the donation, as long as their contact has not had an unexplained illness consistent with hepatitis B in the previous 3 months (sexual partner) or 4 months (household contact). There is no requirement to test the sexual partner or household contact.

Must not donate

a) If:

• it is at least 3 months since sexual contact, and
• it is at least 4 months since household contact, and
• a test for anti-HBc will be performed on the donation,

accept for donation or take samples for testing, as directed by local procedures.

b) If the donor has been tested previously by the Blood Transfusion Service and no new risks are disclosed, accept.

a) If the donor is negative for HBV and Anti-HBc all hepatitis B markers, including anti-HBc, the donor can be accepted. Additional hepatitis B testing is not required for future donations unless the donor discloses a new risk.

b) If any of HBsAg, anti-HBc or HBV DNA are positive, refer to Section 1: Active or recovered hepatitis B infection

a) Known Exposure:
Must not donate.

b) No Known Exposure:
Must not donate if:
Less than seven days since the most recent dose of vaccine was given.

a) Known Exposure:
If it is more than 4 months from the date of exposure, samples can be taken for HBV and anti-HBc testing. No donation should be taken.

b) No Known Exposure:
If it is more than 7 days from the date of the most recent dose of vaccine, accept

a) If the donor is negative for HBV and Anti-HBc, the donor can be accepted. Additional hepatitis B testing is not required for future donations unless the donor discloses a new risk.

b) If any of HBsAg, anti-HBc or HBV DNA are positive, refer to Section 1: Active or recovered hepatitis B infection

Hepatitis A – 4. Immunisation
Immunoglobulin Therapy

Specific HBV immunoglobulin may be used in the management of individuals who have been exposed to hepatitis B. 
Administration of hepatitis B vaccine can lead to low level reactivity in HBsAg screening assays. For this reason, donors must be deferred until at least 7 days after receiving a dose of vaccine, even if they have not been exposed to HBV.
Hepatitis B vaccine is sometimes given in a combined vaccine with hepatitis A vaccine.