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REVIEW article

Front. Immunol.

Sec. Viral Immunology

Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1663306

This article is part of the Research TopicWorld Hepatitis Day 2024: Advancing Hepatitis Elimination, Public Health Strategies and InnovationsView all 20 articles

Transfusion-transmitted occult hepatitis B virus infection (TT-OBI): Current understanding, challenges, and its implication in blood safety

Provisionally accepted
Linbin HuangLinbin Huang1Baoren HeBaoren He1Qiuhong MoQiuhong Mo1BIN LIBIN LI1Yan XipengYan Xipeng1Rongji LaiRongji Lai1Xinwei WangXinwei Wang1Jinlian LiJinlian Li1Mingshuang LaiMingshuang Lai1He XieHe Xie2Jujun SunJujun Sun2Xianlin YeXianlin Ye3*Limin ChenLimin Chen4*
  • 1Nanning Blood Center, 广西南宁, China
  • 2Xi'an XD Group Hospital, Xi'An, China
  • 3Shenzhen Blood Center, Shenzhen, China
  • 4Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Blood Transfusion, Chengdu, China

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Abstract: Occult hepatitis B virus infection (OBI) represents a specific form of hepatitis B virus (HBV)infection characterized by the presence of replication-competent HBV DNA in the liver despite a negative blood test for hepatitis B surface antigen (HBsAg). Due to the incompletely-known mechanisms underlying its occurrence and the limitations of existing screening technologies, the viral loads in the blood of OBI patients are intermittent and often undetectable. Furthermore, lack of effective screening and shielding strategies in blood collection and supply institutions fail to prevent OBI individuals from donating blood, resulting in its susceptibility to transmission through blood transfusion, which poses a significant threat to blood safety. In this review, we summarize current understanding of OBI, challenges, and its implication in blood safety.

Keywords: Occult hepatitis B virus infection (OBI), Blood transfusion transmission, Blood testing, Blood Safety, HBV prevention and control

Received: 10 Jul 2025; Accepted: 07 Oct 2025.

Copyright: © 2025 Huang, He, Mo, LI, Xipeng, Lai, Wang, Li, Lai, Xie, Sun, Ye and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Xianlin Ye, yexianlin90@hotmail.com
Limin Chen, limin_chen_99@yahoo.com

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Supplementary Material