Prevalence of HIV, HBV, and HCV in United States blood donations, 2015-2023: The transfusion-transmissible infections monitoring system (TTIMS).

Abstract

Background: The Transfusion-Transmissible Infections Monitoring System assesses trends in ~60% of the US blood supply. Donors with high-risk behaviors, including injection drug users, men having sex with other men, or those exchanging sex for money/drugs, were deferred for 12 months (12 M) from 2016 to 2020 and 3 months (3M) from 2020 to 2023. Here we evaluate HIV, HBV, and HCV donation prevalence annually from 2015 to 2023 and in two comparison periods of pre-3M (2015-2020) and 3M (2020-2023) to identify differences between the two periods.

Methods: Annual prevalence was assessed for 8 TTIMS years (2015-2023) and compared between the pre-3M and 3M periods. HIV, HBV, and HCV prevalence/100,000 donations (phtd) was calculated based on serology and nucleic acid testing results. Negative binomial regression assessed prevalence using 1-year intervals. Fisher's exact test evaluated prevalence changes between the two periods (α = 0.05).

Results: Annual HIV and HBV prevalence remained stable, changing slightly from year 1 to 8 (2.5-2.1 phtd for HIV and 6.3-6.6 phtd for HBV). HCV prevalence declined (19.7-9.6 phtd; p <.01). HIV (2.5-2.0 phtd) and HCV (18.4-9.8 phtd) prevalence decreased from pre-3M to 3M (p <.01), while HBV prevalence remained stable (6.5-6.2 phtd; p = .06).

Conclusions: Despite reducing donor deferral periods for many infectious risk behaviors, HIV and HBV prevalence were stable, while HCV prevalence declined over 8 years. Either slight or significant declines occurred from the pre-3M to 3M period for all agents. Thus, changes in policy did not adversely impact the current safety of the blood supply with respect to the major infectious disease agents.