Viruses (Feb 2023)

Hepatitis B Blood Donor Screening Data: An Under-Recognized Resource for Canadian Public Health Surveillance

  • Sheila F. O’Brien,
  • Cassandra N. Reedman,
  • Carla Osiowy,
  • Shelly Bolotin,
  • Qi-Long Yi,
  • Lillian Lourenço,
  • Antoine Lewin,
  • Mawuena Binka,
  • Niamh Caffrey,
  • Steven J. Drews

DOI
https://doi.org/10.3390/v15020409
Journal volume & issue
Vol. 15, no. 2
p. 409

Abstract

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Hepatitis B surveillance is essential to achieving Canada’s goal of eliminating hepatitis B by 2030. Hepatitis B rates, association of infection with vaccine age-eligibility, and risk factors were analyzed among 1,401,603 first-time Canadian blood donors from 2005 to 2020. Donors were classified as having likely chronic or likely resolved/occult infections based on hepatitis B surface antigen, anti-hepatitis B core antigen, and hepatitis B nucleic acid test results. Likely chronically infected and control donors (ratio 1:4) participated in risk-factor interviews. The 2019 rate of likely chronic infection was 61.9 per 100,000 (95% CI 46.5–80.86) and 1449.5 per 100,000 for likely resolved/occult infections (95% CI 1370.7–1531.7). Likely chronic infections were higher in males (OR 3.2; 95% CI 2.7–3.7) and the vaccine-ineligible birth cohort (OR 1.9; 95% CI 1.6–2.2). The main risk factors were living with someone who had hepatitis (OR 12.5; 95% CI 5.2–30.0) and ethnic origin from a high-prevalence country (OR 8.4; 95% CI 5.9–11.9). Undiagnosed chronic hepatitis B may be more prevalent in Canada than currently determined by traditional passive hepatitis B reporting. Blood donor data can be useful in informing hepatitis B rates and evaluating vaccination programs in Canada.

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