Journal of African Development

Background & objectives: Hepatitis B virus (HBV) infection remains an important cause of transfusion-transmitted infections despite routine hepatitis B surface antigen (HBsAg) screening. Anti-hepatitis B core immunoglobulin M (anti-HBc IgM) is a marker of recent HBV infection and may be associated with subclinical hepatic injury. The present study aimed to evaluate the hepatic biochemical profile according to anti-HBc IgM reactivity among apparently healthy blood donors.

Methods: This hospital-based cross-sectional study included 115 apparently healthy voluntary and replacement blood donors recruited between December 2023 and March 2024. Donors were classified into anti-HBc IgM reactive (n=9) and non-reactive (n=106) groups based on serological status. Serum total bilirubin, aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase were estimated using an ERBA EM-200 automated clinical chemistry analyser. Comparisons between groups were performed using the independent Student's t-test.

Results: Anti-HBc IgM reactive donors demonstrated significantly higher mean serum total bilirubin (1.96±0.48 vs. 0.85±0.22 mg/dL), AST (68.77±11.92 vs. 32.45±8.56 U/L), ALT (74.33±14.85 vs. 34.90±9.14 U/L), and ALP (186.11±37.02 vs. 104.52±24.17 U/L) than non-reactive donors (all *P*<0.001). Elevated hepatic biochemical parameters were also more frequently observed among anti-HBc IgM reactive donors.

Cconclusions: Apparently healthy blood donors with anti-HBc IgM reactivity exhibited significant hepatic biochemical abnormalities compared with non-reactive donors, suggesting the presence of subclinical hepatic involvement despite the absence of clinical symptoms. Assessment of hepatic biochemical parameters may complement donor evaluation and improve understanding of early HBV-associated liver injury. Further multicentre studies with larger sample sizes and molecular confirmation are warranted