Fu, Michael XMichael XFuFaddy, Helen MHelen MFaddyCandotti, DanielDanielCandottiGroves, JamelJamelGrovesSaa, PaulaPaulaSaaStyles, ClaireClaireStylesAdesina, OpeyemiOpeyemiAdesinaCarrillo, Jose PerezJose PerezCarrilloSeltsam, AxelAxelSeltsamWeber-Schehl, MarijkeMarijkeWeber-SchehlO'Brien, Sheila FSheila FO'BrienDrews, Steven JSteven JDrewsAidoo, Nana BenyinNana BenyinAidooPajares, Ángel LuisÁngel LuisPajaresPerez, Laura NavarroLaura NavarroPerezDeng, XuelianXuelianDengvan de Laar, ThijsThijsvan de LaarLaperche, SyriaSyriaLapercheLehtisalo, RiikkaRiikkaLehtisaloYilmaz, SonerSonerYilmazTsoi, Wai-ChiuWai-ChiuTsoiJuhl, DavidDavidJuhlNiederhauser, ChristophChristophNiederhauserChenarsabz, NahidNahidChenarsabzO'Flaherty, NiamhNiamhO'FlahertyGoto, NaokoNaokoGotoSatake, MasahiroMasahiroSatakeRenaud, ChristianChristianRenaudLewin, AntoineAntoineLewinCloutier, MarcMarcCloutierSawadogo, SalamSalamSawadogoReynolds, ClaireClaireReynoldsZhiburt, EugeneEugeneZhiburtMuylaert, AnAnMuylaertVan Gaever, VéroniqueVéroniqueVan GaeverGarcia-Otalora, Michel-AndresMichel-AndresGarcia-OtaloraJarvis, LisaLisaJarvisVermeulen, MarionMarionVermeulenBusch, MichaelMichaelBuschBlackmore, StuartStuartBlackmoreJones, AnnAnnJonesBrailsford, SuSuBrailsfordIrving, William LWilliam LIrvingAndersson, MoniqueMoniqueAnderssonSimmonds, PeterPeterSimmondsHarvala, HeliHeliHarvala2024-12-192024-12-192024-11https://boris-portal.unibe.ch/handle/20.500.12422/194402Background Hepatitis B core antibody (anti-HBc) screening has been implemented in many blood establishments to help prevent transmission of hepatitis B virus (HBV), including from donors with occult HBV infection (OBI). We review HBV screening algorithms across blood establishments globally and their potential effectiveness in reducing transmission risk. Materials And Methods A questionnaire on HBV screening and follow-up strategies was distributed to members of the International Society of Blood Transfusion working party on transfusion-transmitted infectious diseases. Screening data from 2022 were assimilated and analyzed. Results A total of 30 unique responses were received from 25 countries. Sixteen respondents screened all donations for anti-HBc, with 14 also screening all donations for HBV DNA. Anti-HBc prevalence was 0.42% in all blood donors and 1.19% in new donors in low-endemic countries; however, only 44% of respondents performed additional anti-HBc testing to exclude false reactivity. 0.68% of anti-HBc positive, HBsAg-negative donors had detectable HBV DNA. Ten respondents did universal HBV DNA screening without anti-HBc, whereas four respondents did not screen for either. Deferral strategies for anti-HBc positive donors were highly variable. One transfusion-transmission from an anti-HBc negative donor was reported. Discussion Anti-HBc screening identifies donors with OBI but also results in the unnecessary deferral of a significant number of donors with resolved HBV infection and donors with false-reactive anti-HBc results. Whilst confirmation of anti-HBc results could be improved to reduce donor deferral, transmission risks associated with anti-HBc negative OBI donors must be considered. In high-endemic areas, highly sensitive HBV DNA testing is required to identify infectious donors.enHBV screeningNATanti‐HBc testingblood transfusionsafety600 - Technology::610 - Medicine & healtharticle10.48620/786463935911210.1111/trf.18018