[Epidemiological Characteristics and Trends of HBV Among Blood Donors in Wuhan, 2016-2024]

To analyze the seroepidemiological characteristics and trends of hepatitis B virus (HBV) infection among blood donors in Wuhan from 2016 to 2024, providing data support for monitoring blood safety and evaluating the effectiveness of blood screening.

A total of 2 026 372 blood samples from Wuhan Blood Center from January 2016 to December 2024 were analyzed. The blood samples were tested using two enzyme-linked immunosorbent assay (ELISA) kits for hepatitis B surface antigen (HBsAg) and one nucleic acid testing (NAT) kit. Samples with reactive results in both HBsAg ELISA tests were defined as HBsAg-positive, while samples with non-reactive HBsAg but reactive HBV NAT results were defined as NAT-positive. HBV prevalence was calculated per 100 000 donations. Demographic characteristics such as age, sex, and marital status, as well as birth cohort and donation frequency were collected, and the characteristics and temporal trends of HBV infection among blood donors were analyzed. The χ² test was used to assess differences in HBV prevalence across subgroups. Temporal trends in HBV prevalence were analyzed by linear regression. Risk factors associated with HBV infection were identified using logistic regression.

From 2016 to 2024, there were 5 237 HBV-positive cases among blood donors in Wuhan, with an overall prevalence of 258.44 per 100 000 donations. This included 3 945 HBsAg-positive cases (prevalence: 194.68 per 100 000 donations) and 1 292 NAT-positive cases (prevalence: 63.76 per 100 000 donations). HBsAg prevalence initially declined (2016-2021), followed by a slight increase (2022-2024), with the rate of 2024 (224.50 per 100 000 donations) being 28.25% lower than that in 2016 (312.90 per 100 000 donations). Univariate analysis showed that male donors (OR=1.490, 95%CI: 1.400-1.586, P<0.001) and married donors (OR=4.060, 95%CI: 3.824-4.311, P<0.001) had a significantly higher risk of HBV infection. The risk of HBV infection increased with age, and the highest risk was observed in donors aged over 45 years (OR=8.138, 95%CI: 7.473-8.862, P<0.001). Donors born after 1992 (OR=0.336, 95%CI: 0.314-0.359, P<0.001), repeat donors (OR=0.094, 95%CI: 0.085-0.103, P<0.001), ethnic minority donors (OR=0.660, 95%CI: 0.565-0.772, P<0.001) and AB blood type donors (OR=0.850, 95%CI: 0.764-0.946, P=0.003) had a significantly lower risk of HBV infection. Age-stratified trend analysis showed a significant decline in HBsAg prevalence in the 18-25 years group (β=-0.930, P<0.001), 26-35 years group (β=-0.885, P=0.001), and 36-45 years group (β=-0.792, P=0.011), but no significant temporal trend was found in the group over 45 years old. The trends of HBV NAT prevalence in all age groups were not significant. HBsAg prevalence declined significantly in unmarried donors and those born after 1992 (β=-0.888, P=0.001； β=-0.896, P=0.001). Except for unmarried donors and male donors, HBV NAT prevalence showed a significant increasing trend across all other demographic subgroups.

From 2016 to 2024, significant differences in HBV prevalence were observed across various demographic groups among blood donors in Wuhan, though the overall prevalence remained relatively low. This is attributed to the widespread administration of hepatitis B vaccination and the continuous strengthening of blood safety measures. Optimizing the recruitment strategy for blood donors will help further reduce the risk of HBV transmission through blood transfusion.