Rare transmission of hepatitis A virus through blood transfusion products

Viral hepatitis A (VHA) is primarily transmitted via the faecal-oral route. Transmission through blood transfusion products is rare. In 2025, during an ongoing VHA epidemic in the Czech Republic, cases of hepatitis A virus (HAV) transmission through transfusion blood products from an asymptomatic donor were detected. The donor was only found to be HAV positive after developing clinical symptoms. Infected blood transfusion products (leukocyte-depleted erythrocytes and thrombocytes) were administered to two recipients, who subsequently developed infection. One of them, a paediatric patient, presented with anicteric VHA without complications, while the other immunocompromised patient had prolonged viremia. These cases highlight the risk of HAV transmission through blood transfusions, particularly during epidemics. Asymptomatic viremia in donors makes it impossible to detect infection without targeted testing. The introduction of direct nucleic acid testing (NAT) for HAV during a period of increased incidence of infection would improve the safety of blood transfusions.