title: Epidemiology of hepatitis B in Canadian blood donors.
abstract: BACKGROUND
  The residual risk of hepatitis B is higher than for other markers such as human immunodeficiency virus and hepatitis C virus in nonendemic countries. Evaluating the potential for further risk reduction requires a better understanding of the relationship between donor selection criteria, immigration from endemic countries, and public health vaccination strategies.
  
  
  METHODS
  Age and sex trends of hepatitis B surface antigen (HBsAg)-positive donors from 1997 to 2006 were analyzed using a Poisson model. All HBsAg-positive donors in 2005/2006 plus four matched control donors for every HBsAg-positive donor who participated were invited to participate in a risk factor interview and predictors of HBsAg positivity identified by logistic regression. A survey of 40,000 donors who did not react for all markers asked about vaccination history and country of birth.
  
  
  RESULTS
  Most HBsAg-positive donations were from first-time donors (86%), have been decreasing in donors under the age of 30 (p < 0.01), and were correlated with geographic regions with more donors from higher-prevalence countries (p < 0001). Birth in a higher-prevalence country predicted HBsAg positivity (p < 0.01). Fifty-six percent of donors reported being vaccinated for hepatitis including approximately 80 percent of donors under age 30 who reported being vaccinated as part of regular school programs.
  
  
  CONCLUSIONS
  HBsAg-positive donations are decreasing in donors under age 30, those most frequently vaccinated through provincial vaccination programs. HBsAg-positive donations largely reflect immigration from high-prevalence countries without other deferrable risk factors, mainly chronic cases that will be detected by current testing. Furthermore, risk of incident infections should decrease with increasing vaccination rates in donors, especially the younger cohort now receiving universal vaccination.
authors.affiliation: Canadian Blood Services, Ottawa, Ontario, Canada. sheila.o'brien@blood.ca
authors.forename: Sheila F
authors.initials: SF
authors.lastname: O'Brien
authors.forename: Guoliang
authors.initials: G
authors.lastname: Xi
authors.forename: Wenli
authors.initials: W
authors.lastname: Fan
authors.forename: Qi-Long
authors.initials: QL
authors.lastname: Yi
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Fearon
authors.forename: Vito
authors.initials: V
authors.lastname: Scalia
authors.forename: Mindy
authors.initials: M
authors.lastname: Goldman
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa / Q000208:ethnology; D000367:Age Factors; D001208:Asia / Q000208:ethnology; D001782:Blood Donors / Q000706:statistics & numerical data*; D002170:Canada / Q000453:epidemiology; D016022:Case-Control Studies; D054242:Emigrants and Immigrants; D019353:Endemic Diseases; D005060:Europe / Q000208:ethnology; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology* / Q000208:ethnology; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D017325:Hepatitis B Vaccines / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012306:Risk; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D011795:Surveys and Questionnaires; D014481:United States / Q000208:ethnology; D014611:Vaccination / Q000706:statistics & numerical data
chemical_list: D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines