The prevalence of hepatitis B core antibody positivity in donors for liver transplantation in Saudi Arabia

OBJECTIVE: The risk of transmitting hepatitis B virus from donors who are positive for hepatitis B core antibody but negative for hepatitis B surface antigen has been a major concern in liver transplantation. In the Kingdom of Saudi Arabia the overall prevalence of hepatitis B core antibody among the general population was reported to be very high indeed. The purpose of this study is to establish the prevalence of hepatitis B core antibody positivity among liver donors who are negative for hepatitis B surface antigen and offered for liver transplantation in the Kingdom of Saudi Arabia.

METHODS: Hepatitis B serological markers were studied in 145 of 209 donors offered for organ transplantation over a 4-year period in King Fahad National Guard Hospital, Riyadh, Kingdom of Saudi Arabia.

RESULTS: Out of 145 donors, 51 donors tested positive for hepatitis B core antibody but negative for hepatitis B surface antigen with an over all prevalence of 35.2%. The majority of donors were non-Saudi (75.2%), and predominantly from the Indian subcontinent and Far East. The prevalence of hepatitis B core antibody positive donor was significantly higher in non-Saudi (41.3%) compared with Saudi nationals (16.7%).

CONCLUSION: In the view of this high prevalence, we believe that all donors considered for liver transplantation in the Kingdom of Saudi Arabia should be tested for hepatitis B core antibody. Furthermore, an algorithmic approach should be developed to minimize the risk of transmitting hepatitis B virus from donors to liver recipients, at the same time not to affect the existing small pool of available donor organs in the Kingdom of Saudi Arabia.