SUMMARY.Post‐transfusion hepatitis B remains a risk for recipients of hepatitis B surface antigen (HBsAg) screened blood. Anti‐hepatitis B core antibody (anti‐HBc) screening may help reduce this risk. To evaluate its usefulness, 9,238 East Anglian blood donors were screened for anti‐HBc. Those with isolated anti‐HBc were identified with two confirmatory anti‐HBc and anti‐HB surface antibody (anti‐HBs) assays. The prevalence of anti‐HBc reactions in screening and confirmatory assays was 1.29% and 0.35%, respectively. The level of reactivity was significantly higher when two anti‐HBc assays gave concordant results or, being concordant, were anti‐HBs positive. All isolated anti‐HBc‐positive units (0.04%) were negative for additional HBV markers including DNA tested with nested polymerase chain reaction (PCR).A 0.31% prevalence of past HBV infection was found in this population, all carrying both anti‐HBc and anti‐HBs antibody, most above the protective level (0.IU/ml).The proposed screening schemes would limit the number of deferred donors and discarded units and keep the testing time within the remit of routine blood banking practices for an additional cost of approximately £1 per unit. However, no evidence was found in this donor population to suggest that anti‐HBc screening would significantly reduce the incidence
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