Prevalence of occult hepatitis B infection among blood donors from 2015 to 2025: A meta‐analysis based on testing modalities and temporal trends

Abstract Background and Objectives Occult hepatitis B infection (OBI) remains an important concern for global blood safety. Published studies have reported inconsistent OBI prevalence among blood donors, and the influencing factors remain unclear. This meta‐analysis aimed to estimate the pooled OBI prevalence and explore potential sources of heterogeneity. Materials and Methods We retrieved eligible studies published from 2015 to 2026. Pooled prevalence was calculated using a random‐effects model. Subgroup analyses were conducted by testing method, study period, sample size, region, and national hepatitis B virus (HBV) screening conditions. Publication bias and result robustness were assessed via multiple statistical approaches. Results Significant between‐study heterogeneity was identified. All subgroup analyses produced statistically significant interaction results ( p for interaction ≤ 0.015). The prevalence of OBI varied remarkably across subgroups stratified by HBV‐DNA testing method, research period, sample size, geographic region, national HBV endemicity, and blood screening level. The pooled OBI prevalence was higher in the 2023–2024 subgroup, although this likely reflects geographic confounding rather than a genuine temporal increase. No substantial publication bias was detected, and the overall pooled estimate was stable. High residual heterogeneity still persisted in all stratified subgroups. Conclusion OBI is prevalent among global blood donors and affected by detection techniques, study period, sample size, region, and local screening capacity. Standardized molecular testing and long‐term surveillance are recommended to reduce transfusion‐transmitted HBV risks and ensure blood safety.