What is the most common agent transmitted by blood transfusion: human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), or Cytomegalovirus (CMV)?

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From the Guidelines

The most common agent transmitted by blood transfusion is Hepatitis B virus, option (b). This is based on the fact that Hepatitis B virus (HBV) is a highly infectious virus that can be transmitted through blood and blood products, and it has been a major concern in transfusion medicine for many years 1. Although the risk of HBV transmission through blood transfusion has decreased significantly due to routine screening of blood donors and improved donor selection procedures, it is still a significant risk compared to other viruses such as HIV and Hepatitis C 1. Some key points to consider include:

  • HBV can be transmitted through percutaneous or mucosal exposures to blood or infectious body fluids 1
  • The risk of HBV transmission is higher in certain populations, such as persons with hemophilia who receive plasma-derived clotting factor concentrates 1
  • Leukoreduction techniques, which remove white blood cells from blood products, can reduce the risk of HBV transmission, but are not universally implemented 1
  • Routine screening of blood donors for HBV has been in place since 1969 and has significantly reduced the risk of HBV transmission through blood transfusion 1. It's worth noting that while Cytomegalovirus (CMV) is also a common virus that can be transmitted through blood transfusion, the provided evidence does not support it as the most common agent transmitted by blood transfusion.

From the Research

Transfusion-Transmitted Infections

The most common agent transmitted by blood transfusion is a significant concern in the field of transfusion medicine. According to various studies, the answer can be determined by examining the available evidence.

Common Agents

  • Hepatitis B virus (HBV) is a major risk of transfusion-transmitted infection due to the pre-seroconversion window period, infection with immunovariant viruses, and occult carriage of HBV infection 2.
  • Hepatitis C virus (HCV) is also a significant risk, with a residual risk of transmission due to the window period and occult infection 3, 4.
  • Human immunodeficiency virus (HIV) is another agent that can be transmitted through blood transfusion, although the risk has been significantly reduced with the implementation of nucleic acid testing (NAT) 3, 5.
  • Cytomegalovirus (CMV) is also a potential agent that can be transmitted through blood transfusion, although the risk is generally lower than that of HBV and HCV 3.

Prevalence of HBV

  • HBV is the most prevalent transfusion-transmitted infection, with a higher prevalence in countries with poorly developed healthcare systems and limited resources 6.
  • The risk of HBV transmission can be minimized by screening donors, excluding high-risk donors, and implementing NAT 2, 6.

Comparison of Risks

  • The risk of HBV transmission is higher than that of HCV, with an estimated risk of 1 in 63,000 units of blood compared to 1 in 125,000 units for HCV 4.
  • The risk of HIV transmission is significantly lower than that of HBV and HCV, with an estimated risk of less than 1 in 1,000 units of blood 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Transfusion-transmitted infectious diseases.

Biologicals : journal of the International Association of Biological Standardization, 2009

Research

Hepatitis B and blood safety.

Vaccine, 1998

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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