Abstract
Background and ObjectivesIn the era of NAT, strategies to further eradicate transfusion‐transmitted (TT) HCV and HBV should be clarified. Whether or not to introduce NAT for HEV is a controversial issue.Materials and MethodsRecent voluntary reports of suspected TT‐HCV were thoroughly evaluated for causal relationship with transfusion. Donor infection status of HBV was assessed for TT‐HBV in relation to the change of screening strategy.ResultsEven after the introduction of NAT, reports for suspected TT‐HCV continued, almost all of which were denied for TT‐HCV. Window period‐related TT‐HBV was mitigated only with the introduction of individual donation NAT, but there still remains the risk due to the donation with very low viral load below NAT sensitivity. Occult HBV infection‐related TT‐HBV was prevented by total rejection of HBcAb‐positive blood. HEV‐viremic donation could amount to several hundred a year in Japan.ConclusionThe risk of nosocomial HCV infection seems higher than the residual risk of TT‐HCV infection. Individual donation NAT combined with total rejection of HBcAb‐positive donation is the best policy for the eradication of TT‐HBV. Whether or not to screen for HEV should be determined considering viremic donation frequency, HEV transmissibility through transfusion, disease severity, clinical outcome after chronicity, and cost.
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