Journal of Capital Medical University ›› 2025, Vol. 46 ›› Issue (5): 898-906.doi: 10.3969/j.issn.1006-7795.2025.05.020

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Residual risk estimates of transfusion transmissible hepatitis B,hepatitis C and human immunodeficiency virus using P-WP model in Yantai,China,2018 through 2022

Shen Xintang 1，Song Hewei 1，Qu Jiali 1,Zhou Min 2，Wu Xiaoli 1，Wang Xiaohua 3*   

  1. 1.Department of Clinical Laboratory, Yantai Central Blood Station, Yantai 264003, Shandong  Province,  China; 2.Roche Diagnostics China, Shanghai 201106, China;3.Department of Clinical Laboratory, Yantaishan Hospital, Yantai  264000, Shandong  Province, China
  • Received:2025-01-23 Revised:2025-08-30 Online:2025-10-21 Published:2025-10-22

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Abstract: Objective  Estimating the residual risk of transfusion-transmitted diseases  in voluntary blood donors is crucial for monitoring blood safety. and to analyze the evolution trend over a five-year period in Yantai, Shandong Province.   Methods  This study retrospectively reviewed screening data from Yantai Central Blood Station between 2018 and 2022.We compared the positivity rates between first-time and repeat donors, calculated the prevalence of each virus, and estimated the residual risk using the prevalence-window period model. Meanwhile, the age characteristics of all positive donors were analyzed. Results  Over the five-year period, a total of 320 016 individuals donated blood.     The overall reaction rate of transfusion-transmitted diseases was 0. 165%, with HBV (0. 129%) being the most common. The positivity rate among first-time donors ［P(FTDs)］ (0. 310%) was significantly higher than that among repeat donors ［P(RDs)］ (0. 054%)(χ2=312. 783,P<0. 05). The serological residual risks for HBV, HCV, and HIV were 1∶188 090, 1∶1 042 805, and 1∶392 995, respectively. During the five-year period, they decreased from 1∶129 495 to 1∶390 011, from 1∶697 002 to 1∶1 145 826, and from 1∶684 109 to 1∶1 067 317, respectively.The residual risks of HCV and HIV after NAT were 1∶22 369 329 and 1∶6 639 965, respectively, which were significantly reduced by 21. 5-fold and 16. 9-fold, and decreased steadily during the study period. Among the HBV-DNA (+) donors, 61. 8% (68/110) were RDs, and the residual risk was 1∶65  350.  Conclusion  This study demonstrates the remarkable effectiveness of introducing nucleic acid amplification technology (NAT) in reducing the residual risk of HBV, HCV, and HIV, particularly for HCV and HIV. The residual risk for HBV remains higher compared to HCV and HIV due to the discovery of occult HBV infections (OBI). Therefore, a crucial step toward further reducing this residual risk is the use of more sensitive reagents and detection platforms. Furthermore, implementing effective long-term incentive mechanisms and strategic planning to increase the proportion of repeat donors (RDs) is critical for enhancing transfusion safety.

Key words: voluntary blood donors, residual risk, transfusion-transmitted infectious diseases, hepatitis B virus, hepatitis C virus, human immunodeficiency virus

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