The American Red Cross collects blood from a number of defined subsets of the donor population and the proportion of blood collected from each subset varies widely from center to center. A large part of the variation in prevalence of HBsAg may be related to variations in the proportion of blood collected from plants and factories, military units and schools or colleges. We have derived a regression equation, significant at the p˂0.001 level, which links HBsAg prevalence with these collection parameters. Using this equation, we were able to predict the prevalence of HBsAg among first-time donors in 6 of the 9 geographic divisions of the United States with an accuracy exceeding 10%. The predictions for the remaining divisions were within 35% of the actual value. Correlation studies were supported by measurements of true donor prevalence in three blood centers.
The present study was undertaken to determine whether there were any differences in the distribution of hepatitis B virus-(HBV) associated serologic markers among hepatitis B surface antigen-(HBsAg) positive first-time and repeat blood donors. The markers examined in samples from 412 newly identified HBsAg-positive donors (254 first-time and 158 repeat) included HBsAg titer and subtype, HBeAg/anti-HBe, and anti-HBc. Repeat donors were more frequently HBeAg-positive (25.9%) than were first-time donors (17.7%). Anti-HBc and anti-HBe were observed more often among first-time (99.6 and 76%) than repeat (91.8 and 60.8%) donors. No differences were found in the mean HBsAg titer nor in the subtype distribution in the two populations. The frequency of HBeAg positivity and the mean HBsAg titer in blood were significantly lower among first-time donors aged 30 or older as compared to those younger than 30. Such age-related tendencies did not occur among the repeat donors. The profiles of HBV markers suggest that the HBsAg-positive first-time donor group consists predominantly of long-term HBsAg carriers who may have acquired HBV at an early age, while the HBsAg-positive repeat donors have newly acquired infections.
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