{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:16:20Z","timestamp":1792790180094,"version":"4.5.0"},"reference-count":17,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,10,15]],"date-time":"2022-10-15T00:00:00Z","timestamp":1665792000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Grifols Diagnostic Solutions, Inc."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>The efficacy of different screening scenarios in reducing hepatitis B virus (HBV) transmission risk as compared to the risk without screening was modeled in 9,337,110 donations from four geographical regions that had been subjected to hepatitis B surface antigen (HBsAg) and individual donation nucleic acid amplification testing (ID-NAT). We used the Weusten models for estimating infectivity risk for Red Blood Cell (RBC) transfusions in eight HBV infection stages and then evaluated multiple screening strategies based on minipool (MP) and ID-NAT options of different sensitivity for their efficacy in reducing this risk. The efficacy in reducing HBV transmission risk by screening scenarios across the regions varied between 81% (HBsAg only) and 99.2% (ID-NAT and anti-HBc). Highly sensitive ID-NAT alone achieved a slightly higher risk reduction (97.6\u201399.0%) than minipool of 6 donations (MP6)-NAT in combination with HBsAg and anti-HBc (96.3\u201398.7%). In ID-NAT screened lapsed and repeat donors, the additional risk removed by HBsAg testing was minimal (&lt;0.1%). The modeling outcomes in this and two previous reports using this multi-regional database suggest that one could consider an ID-NAT alone testing scenario as an alternative to MP-NAT and serology-based testing algorithms and restrict serologic testing to first-time donors only.<\/jats:p>","DOI":"10.3390\/v14102263","type":"journal-article","created":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T05:08:02Z","timestamp":1665983282000},"page":"2263","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Efficacy of Different Testing Scenarios in Reducing Transfusion-Transmitted Hepatitis B Virus (TT-HBV) Infection Risk"],"prefix":"10.3390","volume":"14","author":[{"given":"Nico","family":"Lelie","sequence":"first","affiliation":[{"name":"Lelie Research, 1811 DK Alkmaar, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Busch","sequence":"additional","affiliation":[{"name":"Vitalant Research Institute, San Francisco, CA 94105, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Kleinman","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of British Columbia, Victoria, BC V6T 1Z4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2399","DOI":"10.1111\/trf.12299","article-title":"Prevalence of HIV-RNA and antibody in first, lapsed and repeat blood donations across five international regions and relative efficacy of alternative screening scenarios","volume":"53","author":"Bruhn","year":"2013","journal-title":"Transfusion"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1111\/trf.13024","article-title":"Relative efficacy of nucleic acid amplification testing and serologic screening in preventing hepatitis C virus transmission risk in seven international regions","volume":"55","author":"Bruhn","year":"2015","journal-title":"Transfusion"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1111\/trf.13819","article-title":"Detection of different categories of hepatitis B virus (HBV) infection in a multi-regional study comparing the clinical sensitivity of HBsAg and HBV DNA testing","volume":"57","author":"Lelie","year":"2017","journal-title":"Transfusion"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1111\/j.1537-2995.2010.02804.x","article-title":"Refinement of a viral transmission risk model for blood donations in seroconversion window phase screened by nucleic acid testing in different pool sizes and repeat test algorithms","volume":"51","author":"Weusten","year":"2011","journal-title":"Transfusion"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1111\/j.1537-2995.2004.04215.x","article-title":"A new strategy for estimating risks of transfusion-transmitted viral infections based on rates of detection of recently infected donors","volume":"45","author":"Busch","year":"2005","journal-title":"Transfusion"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1111\/vox.12889","article-title":"Direct comparison of three residual risk models for hepatitis B virus window period infections using updated input parameters","volume":"115","author":"Lelie","year":"2020","journal-title":"Vox Sang."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2922","DOI":"10.1111\/trf.15420","article-title":"Reassessment of hepatitis B virus window periods for two transcription mediated amplification assays using screening data of South African blood donors","volume":"59","author":"Vermeulen","year":"2019","journal-title":"Transfusion"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2477","DOI":"10.1111\/trf.12165","article-title":"Enhanced detection of hepatitis B virus in Hong Kong blood donors after introduction of a more sensitive transcription mediated amplification assay","volume":"53","author":"Tsoi","year":"2013","journal-title":"Transfusion"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3190","DOI":"10.1111\/trf.16675","article-title":"Residual risk of transfusion-transmitted hepatitis B virus (TT-HBV) infection by NAT screened blood components: A review of observed versus modeled infectivity from donors with window period and occult HBV infections","volume":"61","author":"Lelie","year":"2021","journal-title":"Transfusion"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1111\/trf.14050","article-title":"A mathematical model for estimating residual transmission risk of occult hepatitis B virus infection with different blood safety scenarios","volume":"57","author":"Weusten","year":"2017","journal-title":"Transfusion"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1111\/jvh.13666","article-title":"Infectivity of hepatitis B virus (HBV) surface antigen (HBsAg) positive plasma with undetectable HBV-DNA: Can HBsAg screening be discontinued in Egyptian blood donors?","volume":"29","author":"Ekiaby","year":"2022","journal-title":"J. Viral Hepat."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2459","DOI":"10.1111\/trf.12218","article-title":"Sensitivity of individual donation- and minipool-nucleic acid amplification test options in detecting window period and occult hepatitis B virus infections","volume":"53","author":"Vermeulen","year":"2013","journal-title":"Transfusion"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1111\/trf.14457","article-title":"Sensitivity and specificiaty of a new automated system for the detection of hepatisis B virus, hepatitis C virus and human immunodeficiency virus nucleic acid in blood and plasma donations","volume":"58","author":"Galel","year":"2018","journal-title":"Transfusion"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1111\/j.1537-2995.2007.01276.x","article-title":"Infectivity of blood components with low hepatitis B virus DNA levels identified in a look back program","volume":"47","author":"Satake","year":"2007","journal-title":"Transfusion"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1111\/j.1537-2995.2012.03909.x","article-title":"Residual risk of transfusion-transmitted hepatitis B virus (HBV) infection caused by blood components derived from donors with occult HBV infection in Japan","volume":"53","author":"Taira","year":"2013","journal-title":"Transfusion"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2454","DOI":"10.1111\/j.1537-2995.2009.02322.x","article-title":"Infectivity of human immunodeficiency virus-1, hepatitis C virus and hepatitis B virus and risk of transmission by transfusion","volume":"49","author":"Kleinman","year":"2009","journal-title":"Transfusion"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2046","DOI":"10.1111\/trf.15203","article-title":"Transfusion of HIV-infected blood products despite highly sensitive nucleic acid testing","volume":"59","author":"Cappy","year":"2019","journal-title":"Transfusion"}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/14\/10\/2263\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:54:36Z","timestamp":1760144076000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/14\/10\/2263"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,15]]},"references-count":17,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["v14102263"],"URL":"https:\/\/doi.org\/10.3390\/v14102263","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,15]]}}}