Reporting HBV and HCV Infections in Repeat Blood Donors

What to know

Repeat blood donors are those who have made two or more donations in a 12-month period. An incident infection is defined as a new hepatitis B or C infection within this time period. An incident infection is particularly concerning in a repeat blood donor because they typically do not have common viral hepatitis risk factors.

Why it’s important

Blood collection centers screen each donation using laboratory serologic and nucleic acid tests (NAT) and extensive behavioral risk factor assessments. In some cases, repeat donors may not disclose new behavioral risk factors. Repeat blood donors are considered at low risk for viral hepatitis infection because they are frequently screened. Incident infections in this group can still happen, however.

An incident HBV or HCV infection in a repeat blood donor is of concern not only with respect to the health of the specific donor, but also because it may serve as a sentinel event for a healthcare-associated infection (HAI). Indeed, at least six HAI outbreaks or transmissions (four described in Moorman et al, Transfusion 2015) were detected between 2008 and 2015 by public health investigation of such reports, in each instance from a single donor.

Blood collection centers may voluntarily share with CDC reports of incident hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in repeat donors. CDC can then share information about incident infections with the appropriate state health department so that they can investigate. These incident cases are likely to be a subset of laboratory-reported surveillance cases in that state.

Resources

In 2012, CDC in consultation with state and local health departments released a guide for investigating suspected healthcare–associated viral hepatitis infections.

Upon consultation, CDC can provide assistance to health departments and share best practices based on many states' previous experiences with issues like:

• Infection control breaches previously associated with transmissions in specific settings,
• Practice observation recommendations,
• Guidance for notification messages,
• Populations to screen, and
• Laboratory testing including molecular genetic investigation.

Contacts

For help or technical assistance, contact the Division of Viral Hepatitis at CDC at dvhwi@cdc.gov.

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