AIM:To study the seroprevalence of antibody to hepatitis B core antigen (anti-HBc) in healthy blood donors negative for HBsAg and to evaluate whether anti-HBc detection could be adopted in India as a screening assay for HBV in addition to HBsAg.METHODS:A total of 1700 serum samples collected from HBsAg-negative healthy blood donors were tested for the presence of anti-HBc antibody (IgM + IgG).All samples reactive for anti-HBc antibody were then investigated for presence of anti-HBs and for liver function tests (LFTs).One hundred serum samples reactive for anti-HBc were tested for HBV DNA by PCR method.RESULTS:Out of 1700 samples tested,142 (8.4%)blood samples were found to be reactive for anti-HBc.It was significantly lower in voluntary (6.9%) as compared to replacement donors (10.4%,P=0.011).Seventytwo (50.7%) anti-HBc reactive samples were also reactive for anti-HBs with levels >10 mIU/mL and 70(49.3%) samples were non-reactive for anti-HBs,these units were labeled as anti-HBc-only.These 142 anti-HBc reactive units were also tested for liver function test.HBV DNA was detected in only 1 of 100 samples tested.CONCLUSION:Keeping in view that 8%-18% of donor population in India is anti-HBc reactive,inclusion of anti-HBc testing will lead to high discard rate.Anti-HBs as proposed previously does not seem to predict clearance of the virus.Cost effectiveness of introducing universal anti-HBc screening and discarding large number of blood units versus considering ID NAT (Individual donor nuclic acid testing) needs to be assessed.