Investigation of occult hepatitis B infection in blood donors in Panyu District, Guangzhou

Objective To investigate the status of occult hepatitis B virus infection (OBI) among blood donors in Panyu District of Guangzhou, so as to provide reference for blood transfusion safety. Methods From January 1, 2021 to July 31, 2023, 60 872 blood donors in Panyu District with HBsAg-/HBV DNA+ were screened as OBI subjects. The age, gender and frequency of blood donation of OBI donors were statistically analyzed. HBV DNA viral load was detected and hepatitis B five-panel test was performed. Results The HBsAg-/HBV DNA+positive rate of blood donors in Panyu District was 0.08% (50/60 872). The OBI positive rate of male blood donors was higher than that of female blood donors, with no statistically significant difference(P>0.05). The OBI positive rate of blood donors increased with age, with statistically significant difference(P<0.05). The OBI positive rate of first-time blood donors was higher than that of repeat blood donors, with statistically significant difference(P<0.05). Of the 50 HBsAg-/HBV DNA+ donors, 42 had a follow-up test, among which 14 had no HBV DNA detected. The mean value of the initial screening resolution CT was 37.77. In hepatitis B five-panel test, single HBsAb+ accounted for the highest proportion as 50% (7/14). HBV DNA viral load was detected in 28 cases, and viral load <10 IU/mL accounted for 50%(14/28) and that <200 IU/mL accounted for 96% (27/28). The mean value of initial screening resolution CT was 34.55, mainly HBeAb+/HBcAb+ in hepatitis B five-panel test, accounting for 32.14% (9/28). After multiple follow-up of 24 blood donors, 37.5% (9/24) were detected with viral load, 33.33% (8/24) were detected with no viral load, and 29.17% (7/24) had both negative and positive results. The hepatitis B five-panel test outcome of 29.17% (7/24) donors showed a turnover, while 70.83% (17/24) did not. Conclusion The OBI positive rate is lower in young repeat blood donors. Since OBI is the result of a variety of complex mechanisms, and the existing serological NAT cannot detect all OBI donors, strict pre-donation consultation and screening of previous HBV DNA+ donors are very important for blood safety. It is recommended that patients with weakened immunity, such as organ transplantation, tumor chemoradiotherapy, or the use of immunosuppressive drugs, use virus inactivated blood products.