Prevalence, incidence and residual risk of HBV, HCV and HIV in Turkish Red Crescent blood donors: A 9-year survey initiated with the implementation of nucleic acid testing (2015-2023).

BACKGROUND AND

OBJECTIVES

Nucleic acid testing (NAT) has improved blood safety by shortening the diagnostic window period (WP) for transfusion-transmissible infections. Within the context of a national NAT-based screening programme, this study evaluated temporal trends for hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) among Turkish Red Crescent blood donors between 2015 and 2023.

MATERIALS AND

METHODS

A retrospective analysis was conducted on 22,494,116 blood donations screened by serology and NAT. Prevalence, incidence and residual risk (RR) were estimated using standard incidence/WP models. Temporal trends were evaluated using linear regression, and NAT yield was assessed cumulatively.

RESULTS

The overall confirmed positivity (per 100,000 donors) was 288.5 for HBV, 16.2 for HCV and 14.8 for HIV. HBV and HCV showed significant downward trends (p < 0.01), while HIV rose significantly (p < 0.01). Cumulative NAT yields were 189.35, 2.94 and 2.15 per million donations for HBV, HCV and HIV, respectively. Between 2015 and 2023, the estimated overall RR per million donations declined for HBV (634.79 to 238.34) and HCV (1.69 to 0.99), but rose for HIV (4.08 to 11.40). Notably, the rising HIV RR-contrasting with the decline for HCV-was driven by increasing repeat-donor incidence and differences in the WP models used for risk estimation.

CONCLUSION

While NAT-based screening was associated with low, declining RR for HBV and HCV, the rising HIV trajectory is concerning. This underscores the need for enhanced behavioural screening and donor selection strategies alongside molecular testing to address rising HIV risks.