{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:38:57Z","timestamp":1787027937062,"version":"build-2736575974"},"reference-count":43,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"KAU Endowment (WAQF) at King Abdulaziz University, Jeddah, Saudi Arabia"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Hepatitis B virus (HBV) remains a transfusion-transmissible infection of global concern. While mandatory screening for hepatitis B surface antigen (HBsAg) has reduced overt infections, occult hepatitis B infection (OBI) poses ongoing risk. This meta-analysis aimed to estimate the pooled prevalence of anti-HBc, HBsAg, and OBI in Saudi blood donors, as well as to assess regional variations and temporal trends. Methods: A systematic meta-analysis was conducted using nine studies published between 2013 and 2024, encompassing a total of 87,820 blood donors. Prevalence was pooled using random-effects models with logit transformation and Hartung\u2013Knapp adjustment. Heterogeneity was quantified with I2 and \u03c42. Subgroup analyses examined geographic regions; meta-regression assessed publication year. Publication bias was evaluated with Egger\u2019s regression; sensitivity analyses tested robustness. Results: The pooled prevalence of anti-HBc was 5% (95% CI: 3\u20137%), HBsAg was 0.46% (95% CI: 0.31\u20130.69%), and OBI was 0.12% (95% CI: 0.03\u20130.39%). High heterogeneity was observed (I2 = 90.6\u201398.9%). Subgroup analyses revealed regional disparities, and meta-regression showed no significant temporal trends. Conclusions: The findings suggest that past HBV exposure remains relatively common among Saudi blood donors, while current active infection and OBI are infrequent. These results support continued enhanced screening, including anti-HBc and nucleic acid testing (NAT), to ensure transfusion safety. The lack of a national hemovigilance system that monitors transfusion-transmitted infections among recipients represents a critical gap in Saudi Arabia\u2019s transfusion safety framework. Addressing this gap is essential to fully assess residual risks, evaluate the real-world effectiveness of screening policies, and align with global best practices in blood safety.<\/jats:p>","DOI":"10.3390\/diagnostics15233004","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T11:43:22Z","timestamp":1764157402000},"page":"3004","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Prevalence and Implications of Occult Hepatitis B Virus Infection Among Blood Donors in Saudi Arabia: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8536-6989","authenticated-orcid":false,"given":"Wajnat A.","family":"Tounsi","sequence":"first","affiliation":[{"name":"Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Al-Busafi, S., and Alwassief, A. 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