Long‐term temporal trends in hepatitis B and C among blood donors in Brazil: Prevalence, incidence, and demographic correlates from the REDS multicenter program

BACKGROUND: Viral hepatitis remains a major public health challenge. We evaluated long-term trends in hepatitis B virus (HBV) and hepatitis C virus (HCV) prevalence, incidence, and force of infection (FOI) among blood donors from five Brazilian blood centers and investigated associated demographic factors. STUDY DESIGN AND METHODS: Data from the NHLBI Recipient Epidemiology and Donor Evaluation Study program were analyzed. Prevalence was estimated among 2,062,816 first-time donors for HBV (2008-2023) and 1,673,745 for HCV (2012-2023). Incidence was estimated among 1,346,256 repeat donors for HBV and 1,151,209 for HCV. Active HBV infection was defined by reactive HBsAg and anti-HBc or reactive HBV nucleic acid testing (NAT), and active HCV infection by reactive NAT. Historical FOI was estimated using a Bayesian serocatalytic model. RESULTS: Active infection prevalence was 136.2 per 100,000 donors (95% CI, 131.2-141.3) for HBV and 57.4 (95% CI, 53.8-61.1) for HCV. Incidence rates were 3.54 (95% CI, 3.01-4.11) and 3.99 (95% CI, 3.33-4.72) per 100,000 person-years, respectively. Prevalence decreased annually by 7.6% for HBV and 11.0% for HCV. Higher prevalence and incidence were associated with male sex, older age, lower educational attainment, and Black or mixed-race skin color. Regional differences persisted, and FOI declined markedly for both infections. DISCUSSION: HBV and HCV prevalence, incidence, and FOI declined substantially among Brazilian blood donors, suggesting reduced transmission, although improved donor selection and screening may also have contributed. Persistent demographic and regional disparities support continued surveillance and targeted prevention.