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Abstract Details
Hepatitis B Blood Donor Screening Data: An Under-Recognized Resource for Canadian Public Health Surveillance
Viruses. 2023 Feb 1;15(2):409. doi: 10.3390/v15020409.
1Epidemiology and Surveillance, Canadian Blood Services, Ottawa, ON K1G 4J5, Canada.
2School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1N 6N5, Canada.
3Public Health Agency of Canada, Ottawa, ON K1A 0K9, Canada.
4National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB R3E 3P6, Canada.
5Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
6Department of Internal Medicine, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
7Center for Vaccine Preventable Disease, University of Toronto, Toronto, ON M5S, Canada.
8Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S, Canada.
9Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S, Canada.
10Public Health Ontario, Toronto, ON M5G 1V2, Canada.
11Héma-Québec, Montreal, QC H4R 2W7, Canada.
12Faculty of Medicine & Health Sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada.
13BC Centre for Disease Control, Vancouver, BC V5Z 4R4, Canada.
14School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
15Medical Microbiology Department, Canadian Blood Services, Edmonton, AB T6G 2R3, Canada.
16Department of Laboratory Medicine & Pathology, Division of Diagnostic and Applied Microbiology, University of Alberta, Edmonton, AB T6G 2R3, Canada.
Abstract
Hepatitis B surveillance is essential to achieving Canada's goal of eliminating hepatitis B by 2030. Hepatitis B rates, association of infection with vaccine age-eligibility, and risk factors were analyzed among 1,401,603 first-time Canadian blood donors from 2005 to 2020. Donors were classified as having likely chronic or likely resolved/occult infections based on hepatitis B surface antigen, anti-hepatitis B core antigen, and hepatitis B nucleic acid test results. Likely chronically infected and control donors (ratio 1:4) participated in risk-factor interviews. The 2019 rate of likely chronic infection was 61.9 per 100,000 (95% CI 46.5-80.86) and 1449.5 per 100,000 for likely resolved/occult infections (95% CI 1370.7-1531.7). Likely chronic infections were higher in males (OR 3.2; 95% CI 2.7-3.7) and the vaccine-ineligible birth cohort (OR 1.9; 95% CI 1.6-2.2). The main risk factors were living with someone who had hepatitis (OR 12.5; 95% CI 5.2-30.0) and ethnic origin from a high-prevalence country (OR 8.4; 95% CI 5.9-11.9). Undiagnosed chronic hepatitis B may be more prevalent in Canada than currently determined by traditional passive hepatitis B reporting. Blood donor data can be useful in informing hepatitis B rates and evaluating vaccination programs in Canada.