The impact of screening a heterogeneous donor population for alanine aminotransferase and hepatitis B core antibody. Experience at a large southern California hospital.

Abstract

To reduce the transmission of non-A, non-B (NANB) hepatitis, the American Association of Blood Banks (AABB) has recommended that donors be screened for elevated levels of alanine aminotransferase (ALT) and for the presence of antibody to hepatitis B core antigen (anti-HBc). In this survey of 5,336 donors, the authors report the impact of using both of these surrogate tests on a heterogeneous donor population that was composed of white, black, Hispanic, and Asian donors. Hispanic and male donors had relatively high ALT levels, and black and Asian donors had a higher prevalence of anti-HBc than their respective counterparts. The overall impact of using both surrogate tests resulted in a discard rate of 12.1% with a disproportionately high percentage of Hispanic and male donors excluded because of ALT testing and black and Asian donors because of anti-HBc testing. It appears that surrogate testing has a much greater impact on blood collection facilities that rely considerably on Hispanic, Asian, black, or male donors than those that largely draw white or female donors.