About 4 years ago, I went for my quasi-regular stint at donating blood. About a week later I received notice that my blood was no longer wanted! They had found Hepatitis B antibodies. No Hepatitis B antigens. No Virus. No evidence of virus. Except that I was now producing antibodies. I asked the guy at the hospital and also my physician who told me they were just being careful. Careful of what? He also told me that I might have been exposed to Hep B many years ago and I was still producing antibodies. So, why have I had to change from proud donor to ashamed pariah?
Its a rare chance, but the virus could of been some where else in the blood. There would have to be such a minute amount, but there is always a possibility.
Let’s expand this question… I haven’t given blood in well over a year (they stopped coming for us at work). But in that time, I’ve gotten vaccinated for Hep A and B. If this is a normal type vaccination, would I not have Hep B antibodies. Would my blood be refused?
Hey, CC, if you’ve given before without problems, try getting testing again. They could’ve screwed up (but god let’s hope not!)
ok, so the question is: what is the risk to the recipient? If there is no evidence that there is virus in my blood, then what are they afraid of?
Well, technically, the anti-bodies are an indicator of the virus. (ou don’t get anti-bodies in the market, there has to have been some exposure, somewhere.
I suspect that they are being extra cautious. However, after a few people picked up HIV from transfusions, the Red Cross decided the extra cautious was the only way to go. (They are still rejecting any male with any admitted homosexual experience, regardless how long ago or how “clean” they have since tested.)
The policies may be too restrictive, but they took a lot of flak over the spread of HIV and they have probably decided that they will “never again” permit that sort of exposure.
(Yes, I am aware that several of their policies have holes through which one could drive the U.S.S. Enterprise. I am not defending their decisions, only providing a WAG to explain them.)
Antibodies against a virus are an indicator of exposure to either the virus or the vaccine.
A person who responds to hepatitis B (HB) vaccine will become HBsAg seropositive (will have antibodies against HB surface antigen) just as a person who has been infected with HB virus will have them. If the blood bank tests only for HBsAg (which is what I suspect they do), they will be unable to distinguish a person seropositive as a result of immunization from a person seropositive as a result of infection and they will, I gather, discard the blood (unless they want to use the HBsAg antibodies). (If they really want to know whether the seropositivity is more likely to be due to infection than immunization, they can test for other antigens and antibodies that occur as a result of infection but not as a result of immunization but that would be expensive and not necessarily prove that the blood was safe.)
I had hepatitis A during a trip to Mexico in the 70’s and when I went to donate blood months later (this was before AIDS) I was told to forget it forever. They weren’t interested in testing my blood or whether I had hepatitis A or hepatitis B. They just didn’t want to have anything to do with the blood of anybody who have ever had any kind of hepatitis. I don’t think the fear was of either hepatitis A or B but of non-A, non-B transfusion-associated hepatitis (now called hepatitis C) for which there was then no test. Even today, I don’t think the concern is hepatitis B itself. I think they don’t want CC’s blood because people who get hepatitis B tend to be people exposed to other bloodborne diseases such as HIV, hepatitis C, and viruses yet to be identified.
The last time I tried to give blood, I first had to answer a questionnaire about my history. One question asked if I had ever had transplant surgery on my dura, the sheath surrounding the brain and spine. About ten years ago, a piece of the muscle fascia (the sheath around muscles) from my thigh (5 cm x 10 cm) was cut out and sewed into the dura at my upper neck where it meets the cranium. So I asked the technician if this qualified as a transplant, since I myself was the donor.
She was on the phone for about fifteen minutes and then told me that I was banned for life. I have the impression that they just told me this because the person on the other end of the phone didn’t know for sure. Does anyone here know why they ask this question, and whether this surgery should have disqualified me?
As some one who lived in England during the mid 90’s I’m banned from giving blood because of the Mad Cow Disease scare. This is mainly because it will be a good ten years or so before the find out how many people will develop this rather nasty condition.
Kipper,
Are you saying that everyone who lived in England in the mid 90’s is banned from giving blood? What does England do for blood, import all of it?
CurtC :
Dural transplant (though not an autograft) is one of the risk factors for CJD( Creutzfeld-Jacob Disease or prion disease), which are related to all that Mad Cow Disease or BSE that has been happening in Europe.
This is kind of an odd disease that doesn’t really have an honest-to-god infectious agent (it is transmitted by body proteins). Approximately 80% is sporadic, with 15% transmitted and 5% familial. The 15% transmitted is thought to occur by dural and corneal transplants, with the donor (usually cadaveric) having CJD. There is no way to test for it, and it can remain dormant for decades before it presents itself as a fast onset multifocal dementia. Icky disease really.
Amongst the 80% sporadic, some is hypothesized to come from cows or sheep who carry their own form of prion disease. In sheep, it is called scrapie, and in cows bovine spongiform encephalopathy (or BSE), which is what has been happening in Europe over the past few years. Especially England. The transmission to humans is only a hypothesis, however.
Anyway, that’s the reason.
I’m not sure if this makes any sense. It is late. I’ll reread in the morning and clarify, if need be. Most of this information comes from a recent New England Journal of Medicine case presentation about a 68 year old woman with CJD.
I should have added that the disease transmission is largely unknown, and therefore they restrict blood products from anyone who could be at risk. There is some evidence of misfolded prion protein (the instrument of transmission) in muscle cells, white blood cells, and liver cells. Just being safe, ya know.
I was asked to temporarily stop donating. I had elevated ALT levels on two successive donations, which is another indicator of hepatitis exposure. After a year, I went back. They again tested, and my ALT was normal, and I had no hep-antibodies.
About 2 years ago, Canada banned blood from people who lived in the UK for more than 6 months in the last 20 - 25 years (not quite sure of the times).
It’s stupidity… I’d gladly donate blood, but I can’t.
I wonder what they’ll do about now that just about all of Europe has mad cow problems!!
As for blood within the UK, they just use domestic blood. I’m sure the average Brit isn’t worried about it.
Like AWB, I was on temporary hiatus from elevated ALT levels. I was off for one year, but gave it two, just to make sure. Never did really find out why, since the Hep A/B/C/whatever tests came back okay. They just said it was some sort of liver damage.
Ok, if Yeah’s right, then I’m really being rejected for guilt by association. I mean, I never HAD Hepatitis B, for god’s sake. I don’t know how I was exposed to it, but my body seems to be making antibodies to the surface antigen. I don’t have that antigen. I don’t have HIV - they test for that - or any associated high risk diseases. So, despite the quality of the SDMBs, it seems that there is no answer to the question. I see no risk. The blood can be tested for pathogens and there are none. So, what is the caution about? I still don’t know. ok, kids, thanks for the efforts.
My bout with cancer banned me from donating. I was told that because the cause of cancer is not known, they prefer to err on the side of caution. I’m B+ so they used to call me for my blood from time to time.
I will try to help. Not with firm facts (they do not exist; if they were, this thread probably did not exist), but with what I know and with some thoughts based on this knowledge.
In general, blood bakers are very catious. Even more than financial bankers. Because more than freaking money is at stake: human health. Blood is valuable commodity, but they are not desperate and they know that rejected donors can overcome their feelings. Altruism is behind it all. So, now the best donors can do is to stay away from donations.
On top of what Yeah said, they always question themselves: what if the person is HbsAb positive not due to vaccination, but due to the fact, that they failed to detect the virus? Or what if the reaction is positive because of cross-reaction to another, yet unknown hepatitis agent? The possibility of the latter is remote, but is not theoretical zero. It’s better be to safe, than sorry. And lastly. Even if everything is OK, they do not want to give your HbsAb to anyone. Although it will probably not last long in somebody’s bloodstream, there could be a situation in patient’s life when he would need to be tested for his own HbsAb, and the doctors would like to be sure that the Ab are his own.
As far as MCD, so little is known and the appearing risk is so high, that they do not want any eventualities. Statistical one millionth of a chance to become infected when you personally are infected becomes too much. Another donor can be used.
“…then I’m really being rejected for guilt by association.”
That’s right. Just like the people who lived in England in the mid 90’s who don’t have mad cow disease.
“…I never HAD Hepatitis B…”
Yes you did, it just didn’t make you sick. That’s not at all unusual.
“I see no risk. The blood can be tested for pathogens and there are none.”
The blood can only be tested for pathogens we know about.
“So, what is the caution about? I still don’t know.”
I think they don’t want your blood because people who get hepatitis B tend to be people exposed to other bloodborne diseases such as HIV, hepatitis C, and viruses yet to be identified.
I am not convinced that blood banks always make the most rational decisions about whose blood to accept and whose to reject, but it is hard to argue with people who say they are “just being careful.” They are being careful even if you think they are also being foolish.
I lived in England from 1978-1981, and I am also banned from blood donation. My understanding is that anyone who lived there from the late '70s through the mid 90s is considered a risk for MCD.
I’m a double threat.
I’m one of those folks who tested positive for Hep B antibodies twice (even though a later test by my physician conclusively proved that false), so I’m banned for life, regardless of the facts.
Plus, I lived in the UK for more than 6 months in the 90s.
I have a lovely O+ blood and used to give regularly, but now I can’t, and on top of it all I have to put up with co-workers who ask me if I’m afraid or something when I don’t give at company blood drives. Not to mention the guilt when I watch the news every night about how low blood supplies are. Well, gee, guys, I used to be able to give, but now I can’t.
Ugh.