Key Challenges in Screening Blood Donors for Hepatitis B Virus

Technological advancements in blood donor screening have significantly improved blood safety. However, certain testing challenges and limitations continue to face blood banks in donor screening for the hepatitis B virus, resulting in occasional cases of transfusion transmission. These cases are mostly related to donors presenting within the window period and donors with occult hepatitis B infection. There are several other challenges that professionals in transfusion medicine, infectious diseases, gastroenterology, and public health must be aware of. Maintaining the highest test sensitivity is a key parameter for enhancing blood safety, and the review describes current recommendations in this regard, along with relevant advancements. The diversity of viral genotypes and the potential for mutations affecting the surface antigen may negatively affect the performance of both serologic and nucleic acid tests. Serologic tests may also be affected by several interferences, endogenous or exogenous to the sample. A clear understanding of these challenges is necessary to create effective policies and procedures and to properly manage atypical cases.