Estimation of hepatitis B–positive rates in Chinese blood donors by combining predonation and postdonation screening results

Abstract

Background Chinese blood centers use Hepatitis B surface antigen (HBsAg) rapid test (RT) in pre‐donation and two rounds of screening with different enzyme‐linked immunosorbent assays in post‐donation. Nucleic acid testing (NAT) on screening non‐reactive (SC‐) donations has been gradually implemented since 2010. Yet RT+ and SC‐/NAT+ donors are seldom included in hepatitis B virus (HBV) positive rate estimates in Chinese blood donors. Methods We performed HBsAg neutralization test (NT) on whole blood (WB) with pre‐donation RT+ results and post‐donation screening reactive (SC+) samples from Mianyang and Chongqing in 2015. The annual totals of pre‐ and post‐donation NT+ donors were combined with the annual totals of SC‐/NAT+ donors to derive the estimated HBV positive rates. Result In Mianyang and Chongqing, 59.4% and 68.2% of RT+ donors in Jan‐Aug 2015 contributed for NT, 95.5% and 97.2% of which were NT+ respectively. In 2015, 422 and 667 donors from Mianyang and Chongqing respectively were HBsAg RT+, yielding estimated 403 and 648 pre‐donation RT+/NT+ deferrals. 411 and 668 post‐donation SC+ samples were NT tested from Mianyang and Chongqing, of which 249 and 323 were NT+ respectively. An estimated 63 donors in Mianyang and 88 donors in Chongqing were SC‐/NAT+. The estimated HBV confirmed positive rate in blood donors are 1.59% in Mianyang and 1.01% in Chongqing. Conclusion Pre‐donation HBsAg RT effectively intercepts donations from HBV infected donors. Using NT confirmatory results from RT+, SC+ and SC‐/NAT+ donors, this study provides a model for more accurate estimation for HBV positive rates in China.

The future of blood services amid a tight balance between the supply and demand of blood products: Perspectives from the ISBT Young Professional Council

“…Therefore, POC testing may alleviate the burden associated with asymptomatic carriers and reduce time-to-treatment initiation for test-positive donors. For example, in China, where hepatitis B virus (HBV) infections account for >70% of permanent deferrals [53], rapid pre-donation testing for hepatitis B surface antigen has been gradually implemented since 2010 (in addition to alanine transaminase testing) [54,55]. Such a test was found to effectively capture HBV-infected donations [54].…”

Seroprevalence of Transfusion Transmissible Infections and Associated Risk Factors in Hospitalized Patients before Transfusion in Jinling Hospital Nanjing University: A Three-Year Retrospective Study

“…Enzyme-linked immunosorbent assay (EIA) is one of the most commonly used serological methods to detect hepatitis B surface antigen (HBsAg), HCV antibody (anti-HCV), HIV antibody (anti-HIV), and syphilis antibody (anti-TP) in the laboratory [9]. In the process of EIA, there are various influencing factors, and it is easily affected by interfering substances, which may lead to errors in the results [10].…”