I read through the Red Cross blood donation guidelines yesterday, but I can’t decide whether I qualify for donation or not…I’m hoping one of our medical Dopers can put it to me in straight English.
Here’s the scoop:
About 3 years ago, I was having a liver panel done to try and pinpoint the cause of a problem that I was having. In that series, they evidently requested a screen for hepatitis. My results came back with HepA negative, but HepB antibodies were positive.
I don’t even recall being even remotely ill, and my doctor said not to worry about it.
Under “Hepatitis/Unexplained Jaundice” in the donation guidelines, it states the following:
I believe that the HBsAG was the test I had that came back positive. So…what’s the deal? Can I donate, or do I need some other test first, proving the antibodies are no longer there?
What makes you think the antibodies are no longer there? That’s how immunizations and things like that work–you get the shot, your body manufactures the antibodies, and it keeps them around just in case you should ever step on a rusty nail and need some tetanus antibodies.
You need to get boosters every few years to remind your body to make that kind of antibodies, so it’s possible that the antibodies would be gone. But–
But the Red Cross can’t afford to gamble that your body might ever be free of hepatitis antibodies at any time in the future, hence the permanent deferment for a positive HBsAg test.
I’ve never had the hepatitis vaccines…and, since I was never sick (at least that I noticed), neither I or my doctor have any idea why the antibodies are showing up.
As far as this is concerned…
…am I reading something wrong in the donation guidelines? The portion I quoted doesn’t say permanent deferment, it says to repeat for negative results at any future date. That’s the part I’m questioning…should I ask my doctor to retest, or can I donate and let Red Cross retest? Or am I misunderstanding the posted guidelines entirely, and I am permanently disallowed? I find this hard to believe, because there are tons of people who get hepatitis vaccines who I don’t believe are permanently barred from donating. According to the guidelines again:
HBsAg is hepatitis B surface antigen. If you are HBsAg positive it means that you are a hepatitis B carrier and you are infectious. Most people are only infectious for a while and eventually get over it and become HBsAg negative and HBsAb (hepatitis B surface antibody) positive. They are not infectious and they retain protective antibody for life.
Whether or not you feel sick doesn’t matter.
People who are immunized against hepatitis B become HBsAb positive because the vaccine is a non-infectious dose of HBsAg to which they make antibodies. You can tell whether or not someone who is HBsAb positive got that way from immunization or from being infected by checking for HBcAb. If they are HBcAb positive it means they were infected with the whole HB virus, not just immunized with the HBsAg.
A person who is tested and found to be HBsAg positive should be retested to find out if they are still HBsAg positive. If they are, their intimate contacts should be immunized against HB since they are infectious and they should be evaluated to see if they need treatment. More likely, a follow up test will show that they are no longer HBsAg positive but have become HBsAb positive which is good for them. However, the Red Cross still might not want their blood.
Thank you, Yeah…this is more what I was looking for.
I made my OP from work, and I didn’t have my lab results with me, and I was going from memory. I evidently made a mistake and I am not HBsAb positive, I’m HBsAb positive. I have them here in front of me now, and this is what they say:
HEP A AB IGM - NEGATIVE
HEB B CORE AB G+M - POSITIVE
HEP B SURFACE AG - NEGATIVE
So, from what I’m reading in Yeah’s reply, I have the antibody but not the antigen, which means I am not contagious (which explains the complete lack of concern in my doctor’s part). I was never vaccinated, so I assume it’s pointless for me to ask to have the test that would show HBcAb…I have to assume I was exposed to the whole virus, right?
I’m guessing no one wants my blood in any case. I donated $5 to the Red Cross at my local grocery store today instead.
HEP A AB IGM - NEGATIVE means no evidence of recent infection with hepatitis A virus (Think about getting vaccinated against hepatitis A if you travel to Mexico, South America, Africa, or Asia).
HEB B CORE AB G+M - POSITIVE means infected with hepatitis B in the past, now making antibodies against the hepatitis B core antigen
HEP B SURFACE AG - NEGATIVE means no hepatitis B replication going on (i.e., not making infectious hepatitis B virus)
It’s really quite simple. If you have antibodies to the Hep B core and surface antigens, it means you have been infected at some time in the past with Hep B virus. If you are surface ANTIGEN negative, it means you have cleared the infection and are now “immune.” If you are surface antigen positive, you have an ongoing ACTIVE Hep B infection, and are infectious. If you are surface antibody positive and have been vaccinated, it means you have become immune via vaccination, and you are not infectious. You amy donate blood. If you are core antibody positive and surface antibody negative, that is problematic. It means you have been infected with Hep B and have not mounted a surface antibody response. Before we had an HIV test, people who were HVsAB negative/HBcAB positive were deemed suspect for AIDS (such as it was defined then) and recommendation was not to use their blood for transfusion. Such individuals are still excluded from blood donation, as are those who are HBcAb postive.
