Significance of HBV NAT and HCV NAT in the Detection of HBV Infection and HCV Infection in Seronegative Blood Donors At Regional Laboratory and Central Blood Bank in Al Madinah, Saudi Arabia

A BSTRACT Bloodborne infections such as Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) pose a significant risk during blood transfusions. Serological tests are the primary screening method, but they have limitations during the “window period” when antibodies have not yet developed. Objectives: This study aimed to evaluate the significance of nucleic acid testing (NAT) for HBV and HCV in detecting infections among seronegative blood donors in Madinah, Saudi Arabia. Materials and Methods: This study is a retrospective study that analyzed data from 15968 blood donors who visited Regional Laboratory and Central Blood Bank in Madinah between January 2021 and December 2023. Data collection included demographic data which included sex and age and laboratory data which included serological testing for HBsAg, anti-HBc, anti-HBs, anti-HCV, and NAT testing. Results: A total of 518 donors (3.2%) were tested for seroprevalence of HBV infection. Among those blood donors, 85 (0.5%) tested positive for HBsAg and anti-HBc while 433 (2.7%) tested negative for HBsAg and positive for anti-HBc. Among those, 433 were HBsAg negative and positive for anti-HBc donors, 6 (0.04%) were positive Anti-HBsAg, while 427 (2.66%) were negative Anti-HBsAg. However, most of them had shown also nonreactive HBV-NAT testing results ( n = 416, 2.59%) but 11 (0.07%) have revealed reactive HBV-NAT testing results. Out of the 15,450 donors who tested negative for all serological markers (anti-HBc, anti-HBs, and HBsAg), six donors were identified as positive by HBV-NAT. Similarly, one donor (0.006%) was positive for HCV-NAT. Conclusion: This study demonstrates the crucial role of HBV and HCV NAT in identifying infected blood donors who might be missed by serological testing alone. Implementing NAT alongside serology enhances blood safety by reducing the risk of transfusion-transmitted infections.