About 15 years ago, after having donated blood many times, I was told that I had antibodies for Hep B and could therefore no longer donate. I had no viruses, just antibodies. My doc told me at the time that I may have been exposed to Hep B years and years ago - and may have never had the disease - hence the antibodies, but the rule says that if you have them, you can’t donate. I never knew why that would be, since without the virus, my blood should be fine (and maybe even better, with the anti-bodies), and I’m now wondering if I’m good to go again. Has the state of the art advanced to where I might be of some benefit again to society by donating?
This is a question best for your blood bank. There are a variety of rules that can disqualify someone from donating (you can’t be too careful). I happened to spend a day in a country that has malaria (Nicaragua) and was differed for a year as a result, and once I had an elevated liver enzyme (ALT - Alanine transaminase) and was differed for 2 year before I was reinstated. In both cases I didn’t have any disease that anyone could find, but that didn’t matter.
Details about Hep B and donating blood can be found here: FAQs About Blood and Blood Donation
But basically just because one’s viral load is not detectable, or one is now antigen free, that does not automatically mean that there is no virus present. Some cases of Hep B infection via blood were traced to individuals who were HBV core Ab positive, but antigen negative (implying the virus is gone, or very, very reduced). While a rare occurrence, excluding folks who did have a HBV infection at one time from donating ensures that such transmission is even rarer.
That’s the trouble with HBV infections. While most folks get over the infection, “Inactive carrier” state is quite common, meaning the person is quite healthy, viruses seem to be absent, but they’re not.
So getting the Hep B vaccine doesn’t cause antibodies to show up?
Only surface antibodies. Hep B vaccine uses a viral surface antigen protein to induce immunity. One can tell if someone is naturally immune from a previous infection because they’ll have both Hep B core AND surface antibodies. If they had the vaccine, they won’t have core antibodies, only surface antibodies.
deferred
I once tried to donate blood (in New York), but they would not take it solely because I had lived in the U.K. - due to concerns over BSE/CJD. No specific risk factors, no testing. A lot of people were annoyed because they had sent out a specific blood drive email to us in my lab, where about 30% of us were European. Almost all the Europeans were being turned away after waiting half an hour to donate based on the first interview question - “have you lived in Europe?”.
Qadgop, does all of this apply to a past Hepatitis A (HAV) infection as well?
I ask because I contracted an acute case of Hepatitis A when I was in college nearly 30 years ago. (I got it in a restaurant as a food-borne illness. Some restaurant worker didn’t wash his hands, and started his own little epidemic.)
Anyway, I completely recovered from the infection. About 8 years later, I reported this history of Hep A to a dentist, who insisted on a blood test before he would treat me. The blood test came back “negative.” What exactly does that mean?
Ever since I recovered from that Hep A infection, I’ve been told that any past history of hepatitis after age 11 is disqualifying for blood donation, according to the American Red Cross and your previous link. I therefore don’t donate blood (which I always feel bad about).
Is this because because my donated blood could potentially cause someone else to get infected with Hep A, or are they just screening out everyone with any history of hepatitis to ensure that they screen out people with one of the chronic varieties of hepatitis?
Note that I am not questioning the deferral. I’m just wondering what the reasoning is behind it.
I’ve asked this question several times over the years, and have never gotten a straight answer.
Robby, I’m not sure I can improve on the answer KarlGauss gave you a few years ago: Question about blood donation and Hepatitis A - Factual Questions - Straight Dope Message Board
Hep A is not blood-borne in the first place, it’s from the old fecal-oral route. But frankly if a patient tells me he thinks he had Hep A at some point, I figure there’s at least a 25% chance it was really Hep B or Hep C, unless I’ve got good documentation to the contrary.
So it’s just easier to exclude everyone with a history of any type of hepatitis. It excludes a lot of folks who could donate safely, but probably prevents a handful of infections a year.
My family and I lived in England from 1988 to 1992. The fear of "Mad Cow"stops them from giving blood. I had Hep A as a child so I can’t anyway.
Thanks for the reply, Qadgop. I did say that I’ve asked the question before…apparently over nine years ago! :smack: I’d completely forgotten that I actually started a thread on this. I’m glad to see that my recollection of the pertinent facts matches up fairly well, at least.
And you’re right, that was an excellent, in-depth answer that KarlGauss gave. I have no idea why I never replied back to thank him. In addition, I withdraw my erroneous statement that I’ve never gotten a straight answer before.
I know that the fecal-oral route is how Hep A is transmitted, but what does it mean that Hep A is “not blood-borne”? After all, that dental clinic tested my blood, and KarlGauss was discussing antibodies in the bloodstream. Or am I conflating two different things?
For me, I am as positive as I can be that I had Hep A (and not Hep B or Hep C), but unless I can track down my medical records from three decades ago, I have no way to prove this with documentation.
When I think about this rationally, I understand where they’re coming from, but it’s still aggravating.
Upon re-reading KarlGauss’s response, he also indicated there are no long term effects from an acute Hep A infection. And with the importance of donating blood, I’m surprised that there is no acceptable blood test that could prove this to the satisfaction of health officials. It’s too bad that someone who recovers from an acute infection of Hep A is forever barred from donation.
For someone who is perfectly willing to donate blood if it were allowable, it’s maddening to hear the constant appeals to donate, to know that there is nothing wrong with my blood, but to be forever banned from donating. My son has donated blood exactly once, and we now get daily phone calls and monthly post cards imploring him to donate again. In my office, we have quarterly blood drives, and our Scout troop has an annual blood drive, and I’ve never been able to donate. 
What worse is that I get lumped in with all the wusses in my office who refuse to donate because they’re afraid of needles or something. :rolleyes:
robby, blood-borne means that the infection is transmitted via contact with infected blood, usually through injection but also by open wounds, or consuming the blood. Hepatitis A is not passed that way. The body fights the virus off by forming antibodies, which circulate in the blood.
And it is frustrating to not be able to donate, but the most basic principle of medicine is primum non nocere, or “First, do no harm”. Transfusions and blood products are life-saving in many circumstances, but infusing someone with the wrong or infected blood/blood product will do harm. To keep the risk acceptably low, the bar is set very high to be able to donate.
Yes, for some people it could be proven beyond a reasonable doubt that their blood is safe, despite those screening disqualifications. But it would take a variety of somewhat esoteric, and expensive tests, individualized for that particular donor, to prove the blood to be safe. Easier to screen folks out, and then do less esoteric (yet still multiple and elaborate) tests on the blood collected to ensure safety of the blood product.
Dealing in blood products is high tech, it’s complicated, it’s regulated by a myriad of federal and state laws, and when a single bad outcome due to failure of the screening process occurs it’s national news, with lots of fear, angry accusations, heads rolling, and a LOT of work to track down anyone and everyone who may have been affected by it. So responsible health professionals try to reduce the risks down as close to zero as they can, while ensuring adequate product out there to save lives.
And reducing the risks in that manner makes some potential donors feel bad. But donating blood is not a right, it’s a privilege awarded not due strictly to merit or hard work, but by happenstance as much as any other factor. Those who cannot donate blood can go work in a soup kitchen, mentor at-risk kids, raise money for homeless shelters, etc.
And I’m happy when certain restrictions on donating can be lifted. But they need to be lifted due to such donations being found to be acceptably safe, not due to social or political pressure.
Thanks, Qadgop. That all makes sense.
All I know is that I stopped getting calls from the local agency. Symptom free without the guilt.
Doctor: “The tests are more sensitive now. I could run another titre.”
Me: “No, thanks. I like it how it is.”
Update…the guidelines have apparently changed:
[ul]
[li]Requalification of Donors Previously Deferred for a History of Viral Hepatitis after the 11th Birthday; Guidance for Industry[/li][li]American Red Cross Eligibility Criteria[/li][/ul][ul]
[/ul]
The first link from the FDA removes the recommendation to exclude donors with a history of Hepatitis A after the 11th birthday. It maintains the recommendation to prohibit donors with a history of Hepatitis B or Hepatitis C.
The second link from the American Red Cross now states:
(The previous guidance stated that any past history of hepatitis after age 11 is disqualifying for blood donation. It did not distinguish between the various types of hepatitis.)
Also, my doctor has since confirmed a past Hepatitis A exposure with a blood test specifically looking for this.