From the Guidelines
The most common agent transmitted by blood transfusion is hepatitis B virus, option (b). This is due to the fact that even with the greater than 99% sensitivity of the current tests for HBsAg, not all HBV carriers are detected by screening for HBsAg, and a small number of transfusion recipients still develop hepatitis B 1. The current incidence of post-transfusion hepatitis B is estimated to be around 0.002%/transfusion recipient 1. While Cytomegalovirus (CMV) is also a concern, particularly for immunocompromised recipients, premature infants, and seronegative pregnant women, the provided evidence does not support it as the most common agent transmitted by blood transfusion in this context. Key points to consider include:
- The decline in the incidence of post-transfusion hepatitis B, which occurred before anti-HBc testing was initiated and was temporally associated with changes in the donor population related to the prevention of human immunodeficiency virus (HIV) infection 1.
- The fact that transplantation of organs from infectious donors to the organ recipient carried a high risk for transmitting HCV infection before donor screening, but this risk has been virtually eliminated with the use of anti-HCV-negative organ and tissue donors 1. However, the most relevant information for this question is the incidence of post-transfusion hepatitis B, which is estimated to be around 0.002%/transfusion recipient 1.
From the Research
Transfusion-Transmitted Infections
- The most common agents transmitted by blood transfusion include hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency viruses (HIV-1/2), and Cytomegalovirus (CMV) 2
Hepatitis B Virus Transmission
- Hepatitis B virus (HBV) remains a major risk of transfusion-transmitted infection due to the pre-seroconversion window period, infection with immunovariant viruses, and occult carriage of HBV infection (OBI) 3
- The risk of HBV transmission through blood transfusion has decreased significantly over the years, from approximately 6% of multi-transfused recipients before 1970 to around 1:500,000 to 1:1,000 today 4
Comparison of Transmission Risks
- While hepatitis B virus (HBV) is a significant risk, other viruses like hepatitis C virus (HCV) and human immunodeficiency virus (HIV) are also transmitted through blood transfusion, but the risk of HBV transmission is notable due to its window period and occult carriage 2, 3
- Cytomegalovirus (CMV) is also a transfusion-transmitted infection, but its transmission risk is not as prominent as HBV in the given studies 2