Prevalence of Hepatitis B Virus Infection Among Voluntary Blood Donors from the Northeastern Region of Iran: Genotyping, Viral Load Characterization and Drug Resistance Prediction.

Background Blood donor selection, along with laboratory screening of the HBV, plays a pivotal role in providing safe blood products. This study was aimed to evaluate the prevalence, genotype, and drug resistance prediction of HBV among Iranian blood donors. Methods This cross-sectional study was conducted on 47,506 blood donors referring to Golestan Blood Center from March 21, 2018, to March 20, 2019. Siemens Enzyngnost HBsAg6, INNO-LiPA Genotyping kits, and Nest-PCR were used for HBV screening, genotyping, and amplification of the polymerase gene, respectively. An online tool at hbv.geno2pheno.org and real-time PCR method were also utilized for drug resistance prediction and viral load measurement respectively. Results It was found that from among 47,506 donors, 47 (0.09%) were confirmed to be HBV positive subjects. About 0.94% of first-time blood donors (46 out of 4, 872) and 0.008% of repeated blood donors (1 out of 12,125) were found to be positive for HBV. First-time blood donors were also 8.6 times more likely to have a hepatitis B virus infection (odds ratio: 9.6; 95% confidence interval, 6.2 - 14.7). Seven donors had genotype D as predominant and one case had a mixed infection with genotypes A and D. Furthermore, the most predicted mutation in the polymerase gene was m204V, causing resistance to telbivudine and lamivudine. Conclusions The results showed that the risk of HBV transmission is higher among first-time blood donors. Therefore, it is recommended that predonation laboratory screening in first-time blood donors be conducted to improve the safety of the donated blood in the studied region.