LONG-TERM TRENDS IN HEPATITIS B AND C PREVALENCE, INCIDENCE, AND FORCE OF INFECTION AMONG BLOOD DONORS IN BRAZIL
9 affiliations
- 1Fundação Hemominas, Belo Horizonte, Brazil
- 2Universidade de São Paulo (USP), São Paulo, Brazil
- 3Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
- 4Universidade Municipal de São Caetano do Sul, São Caetano do Sul, Brazil
- 5Hemorio, Rio de Janeiro, Brazil
- 6Fundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE), Recife, Brazil
- 7Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas (HEMOAM), Manaus, Brazil
- 8Fundação Pró-Sangue, Hemocentro de São Paulo, São Paulo, Brazil
- 9Vitalant Research Institute, United States
Abstract
Introduction: Viral hepatitis remains a major challenge for transfusion safety and public health. Long-term blood donor surveillance provides a unique opportunity to monitor HBV and HCV transmission across diverse regions. Methods: Data from the Recipient Epidemiology and Donor Evaluation Study (REDS) program were analyzed. The study included donations from Fundação Pró-Sangue (São Paulo), Hemominas (Minas Gerais), Hemorio (Rio de Janeiro), Hemope (Pernambuco), and Hemoam (Amazonas). Prevalence was estimated among 2,062,816 first-time donations tested for HBV (2008–2023) and 1,673,745 first-time donations tested for HCV (2012–2023). Incidence was estimated among 1,346,256 repeat donors (4,649,415 donations) for HBV and 1,151,209 repeat donors (3,617,529 donations) for HCV. Active HBV infection was defined by reactive hepatitis B surface antigen and anti-hepatitis B core antibody, regardless of nucleic acid testing (NAT) status, or by any reactive HBV NAT result. Active HCV infection was defined by a reactive NAT result regardless of anti-HCV status. Temporal trends were evaluated using Poisson regression, demographic associations using multivariable modified Poisson regression, and historical force of infection (FOI) was reconstructed using a Bayesian serocatalytic model. Results: The prevalence of active HBV infection was 136.2 per 100,000 donors (95% confidence interval [CI], 131.2–141.3), whereas active HCV prevalence was 57.4 per 100,000 (95% CI, 53.8–61.1). After adjustment for demographic characteristics and blood center, prevalence decreased by 7.6% per year for HBV and 11.0% per year for HCV. Incidence was 3.54 per 100,000 person-years for HBV (95% CI, 3.01–4.11) and 3.99 per 100,000 person-years for HCV (95% CI, 3.33–4.72). HBV incidence declined from 12.44 per 100,000 person-years in 2007–2011 to 1.70 in 2019–2023, whereas HCV incidence declined from 7.39 in 2012–2018 to 1.75 in 2019–2023. Male donors had more than twice the HBV prevalence of female donors (186.5 vs. 79.6 per 100,000) and 62% higher HCV prevalence (70.5 vs. 43.5 per 100,000). Infection rates increased progressively with age, were inversely associated with educational attainment, and were higher among Black and mixed-race donors. HBV prevalence was highest at Hemoam and Hemope, whereas HCV prevalence was highest at Hemorio and Fundação Pró-Sangue. FOI declined by approximately 98% for HBV (2.35 to 0.046 per 1,000 susceptible individuals) and 96% for HCV (0.22 to 0.008 per 1,000), indicating a marked reduction in transmission intensity over time. Discussion: The concordant declines in prevalence, incidence, and historical FOI support a sustained reduction in HBV and HCV transmission, likely reflecting the combined effects of vaccination, improved blood safety, expanded access to hepatitis C treatment, and progressively stricter donor screening. As blood donors represent a healthier population, infection estimates may underestimate the burden in the general population. Persistent demographic and regional disparities indicate that progress has not been uniform. Conclusion: HBV and HCV transmission declined substantially among Brazilian blood donors over more than a decade, supporting the effectiveness of integrated public health and blood safety interventions. Continued donor surveillance and targeted prevention strategies remain essential to sustain progress toward viral hepatitis elimination and reduce persistent demographic and regional disparities.
Related
- Literature Review of Occult Hepatitis B Infection and Hepatitis B Core Antibody-Positive Blood Donors.
- Seroprevalence of Hepatitis B Virus Infection and Associated Factors Among Blood Donors at a District Hospital in Ghana: A 2-Year Retrospective Study
- Global trends in the burden of malaria: mapping the prevalence, incidence and mortality of Plasmodium falciparum and Plasmodium vivax in the era of climate change and emerging drug resistance.
- Prevalence of Hepatitis C Infection and Treatment Initiation Following Dried Blood Spot Testing in New South Wales, Australia
- Trends in hepatitis E virus incidence and seroprevalence in the Netherlands, 1988 to 2025.
BibTeX
@article{belisario2026longterm,
title = {{LONG-TERM TRENDS IN HEPATITIS B AND C PREVALENCE, INCIDENCE, AND FORCE OF INFECTION AMONG BLOOD DONORS IN BRAZIL}},
author = {André Rolim BELISÁRIO and Paulo Jeng Chian SUEN and Isabelle Rocha de OLIVEIRA and Teresa Cristina de Abreu FERRARI and Maisa Aparecida RIBEIRO and Carolina MIRANDA and Marcio OIKAWA and Luiz AMORIM and Edyla ALMEIDA and Allyson Guimarães da COSTA and Cesar De ALMEIDA-NETO and Eduard GREBE and Renata BUCCHERI and Michael BUSCH and Brian CUSTER and Ester C. SABINO},
journal = {Hematology, Transfusion and Cell Therapy},
year = {2026},
month = oct,
doi = {10.1016/j.htct.2026.107154},
url = {https://doi.org/10.1016/j.htct.2026.107154},
note = {CC BY},
}
RIS
TY - JOUR
TI - LONG-TERM TRENDS IN HEPATITIS B AND C PREVALENCE, INCIDENCE, AND FORCE OF INFECTION AMONG BLOOD DONORS IN BRAZIL
AU - André Rolim BELISÁRIO
AU - Paulo Jeng Chian SUEN
AU - Isabelle Rocha de OLIVEIRA
AU - Teresa Cristina de Abreu FERRARI
AU - Maisa Aparecida RIBEIRO
AU - Carolina MIRANDA
AU - Marcio OIKAWA
AU - Luiz AMORIM
AU - Edyla ALMEIDA
AU - Allyson Guimarães da COSTA
AU - Cesar De ALMEIDA-NETO
AU - Eduard GREBE
AU - Renata BUCCHERI
AU - Michael BUSCH
AU - Brian CUSTER
AU - Ester C. SABINO
PY - 2026
DA - 2026/10/23
JO - Hematology, Transfusion and Cell Therapy
DO - 10.1016/j.htct.2026.107154
UR - https://doi.org/10.1016/j.htct.2026.107154
AB - Introduction: Viral hepatitis remains a major challenge for transfusion safety and public health. Long-term blood donor surveillance provides a unique opportunity to monitor HBV and HCV transmission across diverse regions. Methods: Data from the Recipient Epidemiology and Donor Evaluation Study (REDS) program were analyzed. The study included donations from Fundação Pró-Sangue (São Paulo), Hemominas (Minas Gerais), Hemorio (Rio de Janeiro), Hemope (Pernambuco), and Hemoam (Amazonas). Prevalence was estimated among 2,062,816 first-time donations tested for HBV (2008–2023) and 1,673,745 first-time donations tested for HCV (2012–2023). Incidence was estimated among 1,346,256 repeat donors (4,649,415 donations) for HBV and 1,151,209 repeat donors (3,617,529 donations) for HCV. Active HBV infection was defined by reactive hepatitis B surface antigen and anti-hepatitis B core antibody, regardless of nucleic acid testing (NAT) status, or by any reactive HBV NAT result. Active HCV infection was defined by a reactive NAT result regardless of anti-HCV status. Temporal trends were evaluated using Poisson regression, demographic associations using multivariable modified Poisson regression, and historical force of infection (FOI) was reconstructed using a Bayesian serocatalytic model. Results: The prevalence of active HBV infection was 136.2 per 100,000 donors (95% confidence interval [CI], 131.2–141.3), whereas active HCV prevalence was 57.4 per 100,000 (95% CI, 53.8–61.1). After adjustment for demographic characteristics and blood center, prevalence decreased by 7.6% per year for HBV and 11.0% per year for HCV. Incidence was 3.54 per 100,000 person-years for HBV (95% CI, 3.01–4.11) and 3.99 per 100,000 person-years for HCV (95% CI, 3.33–4.72). HBV incidence declined from 12.44 per 100,000 person-years in 2007–2011 to 1.70 in 2019–2023, whereas HCV incidence declined from 7.39 in 2012–2018 to 1.75 in 2019–2023. Male donors had more than twice the HBV prevalence of female donors (186.5 vs. 79.6 per 100,000) and 62% higher HCV prevalence (70.5 vs. 43.5 per 100,000). Infection rates increased progressively with age, were inversely associated with educational attainment, and were higher among Black and mixed-race donors. HBV prevalence was highest at Hemoam and Hemope, whereas HCV prevalence was highest at Hemorio and Fundação Pró-Sangue. FOI declined by approximately 98% for HBV (2.35 to 0.046 per 1,000 susceptible individuals) and 96% for HCV (0.22 to 0.008 per 1,000), indicating a marked reduction in transmission intensity over time. Discussion: The concordant declines in prevalence, incidence, and historical FOI support a sustained reduction in HBV and HCV transmission, likely reflecting the combined effects of vaccination, improved blood safety, expanded access to hepatitis C treatment, and progressively stricter donor screening. As blood donors represent a healthier population, infection estimates may underestimate the burden in the general population. Persistent demographic and regional disparities indicate that progress has not been uniform. Conclusion: HBV and HCV transmission declined substantially among Brazilian blood donors over more than a decade, supporting the effectiveness of integrated public health and blood safety interventions. Continued donor surveillance and targeted prevention strategies remain essential to sustain progress toward viral hepatitis elimination and reduce persistent demographic and regional disparities.
SN - 2531-1379
SN - 2531-1387
ER -