Association of Transfusion-Transmitted Infections with ABO and Rh Blood Group System in Healthy Blood Donors in Marrakech, Morocco

Background: TTIs remain a major threat to transfusion safety. This study assessed the association between ABO/Rh blood groups and HBV, HIV, HCV, and syphilis among 4.038 apparently healthy blood donors. Methods: A retrospective cross-sectional study was conducted at the Moroccan Blood Agency and its Derivatives in Marrakech. Serological markers were detected using the Architect i2000SR chemiluminescent microparticle immunoassay (Abbott®, USA). ABO/Rh phenotyping was performed by forward and reverse grouping. Associations were assessed using Pearson’s chi-square test and logistic regression, with adjusted odds ratios. Results: Overall, 885 of 4.038 donors (21.92%) tested positive for at least one TTI marker, for at least one TTI. The highest prevalence of HBV was observed among blood group B donors (9.55%), whereas syphilis was most frequent in group AB (10.76%). HCV prevalence was highest in groups B (3.18%) and AB (3.07%), while HIV prevalence was highest in groups AB (4.61%) and O (4.50%). Regarding the Rh system, HBV, HCV, and HIV prevalence was comparable between Rh-positive and Rh-negative donors (8.94% vs. 8.06%, 2.56% vs. 2.41%, and 4.39% vs. 4.83%, respectively), whereas syphilis was more common among Rh-positive donors (6.71% vs. 4.56%). Compared with blood group O, the odds of HBV reactivity were similar among groups A (p = 0.317), B (p = 0.771), and AB (p = 0.837). Similarly, no significant associations were observed for HCV or HIV across the ABO groups (p > 0.05). For syphilis, donors with blood group AB had higher odds of reactive screening results than those with group O (COR = 1.74, 95% CI: 1.07–2.84; p = 0.025); but overall ABO association was not significant (p = 0.088). Multiple reactive serological profiles were mainly observed among O+ donors (9/16), including two triple-reactive profiles involving HBV, syphilis, and HIV. Conclusions: These findings indicated that ABO and Rh blood group systems were not significantly associated with any reactive serological markers.