Type B hepatitis after transfusion with blood containing antibody to hepatitis B core antigen

N Engl J Med. 1978 Jun 22;298(25):1379-83. doi: 10.1056/NEJM197806222982502.


We tested the hypothesis that donor blood containing antibody to hepatitis B core antigen (anti-HBc) but lacking detectable hepatitis B surface antigen (HBsAg) and antibody (anti-HBs)might transmit Type B hepatitis by examining donor and recipient serums from a Veterans Administration study of post-transfusion hepatitis. Donor blood was available from three patients with Type B hepatitis and from one patient with hepatitis B virus infection (development of anti-HBs and anti-HBc) without symptomatic disease. All four had received 1 unit of blood with high titer of anti-HBc but lacking HBsAg and anti-HBs. In contrast, no such units had been transfused into nine patients with "immunization-like" response (development of anti-HBs without anti-HBc) or into 26 control patients. These data stress the importance of anti-HBc as an indicator of hepatitis B virus infection and support the hypothesis that high-titer anti-HBc-positive blood might be infectious.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Antibodies, Viral* / analysis
  • Blood Donors
  • Carrier State / immunology
  • Hepatitis B / etiology*
  • Hepatitis B / prevention & control
  • Hepatitis B Antibodies* / analysis
  • Hepatitis B Core Antigens* / analysis
  • Humans
  • Serum Globulins / analysis
  • Transfusion Reaction*


  • Antibodies, Viral
  • Hepatitis B Antibodies
  • Hepatitis B Core Antigens
  • Serum Globulins