Update on epidemiology of hepatitis B virus among blood donors in China

Abstract

China is one of the countries with high prevalence of hepatitis B virus (HBV) infection. It is estimated that approximately 100 million people in China are infected with HBV. We aimed to review the prevalence of HBV in Chinese blood donors. With the search term of ‘(hepatitis b virus) and (prevalence or epidemiology) and (blood donors) and (Chinese)’, we searched PubMed (https://www.ncbi.nlm.nih.gov/pubmed) and CNKI (http://www.cnki.net/) for literature in English and Chinese, respectively. The prevalence of hepatitis B surface antigen (HBsAg) in Chinese general population has declined from 9·75% in 1992 to 7·18% in 2006, as a consequence of implementation of nationwide universal neonatal HBV vaccination. The prevalence of HBsAg in blood donors is about 0·49–1·56% by enzyme immunoassays (EIAs) after predonation screening with HBsAg rapid strip test and health consultation, which is significantly lower than that in the general population. HBV DNA is detected by nucleic acid tests (NATs) at a rate of 0·01–0·11% among HBsAg‐negative blood donors, which is identified mostly as occult HBV infection (OBI). The prevalence of HBV in Chinese blood donors is about 1%. In contrast to countries with low HBV prevalence, anti‐HBc testing cannot be applied to routine screening of HBV infection because the high anti‐HBc prevalence in Chinese blood donors would lead to unacceptably high donor deferral. Therefore, to further reduce transfusion transmission of HBV, it is of great necessity to apply highly sensitive NAT to test HBV DNA in Chinese blood donors.