Blood transfusion is an integral component of modern medical care; however, it is associated with the risk of transmission of infectious agents. Transfusion-transmissible infections (TTIs), including human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis, and malaria, represent a significant public health concern worldwide. Despite stringent donor screening and mandatory testing, TTIs continue to occur, particularly in developing countries such as India 1,2. India bears a substantial burden of viral hepatitis and HIV, contributing to an increased risk of transfusion-related infections. Several studies from different regions of the country have reported varying prevalence rates of TTIs among blood donors, with hepatitis B consistently emerging as the most common infection³,4,⁵. Replacement blood donors, in particular, have been shown to carry a higher risk of TTIs compared to voluntary donors ⁶. Periodic evaluation of the pattern of TTIs among blood donors helps in understanding regional epidemiological trends, assessing the effectiveness of donor selection criteria, and formulating strategies to improve blood safety. The present study was undertaken to assess the pattern and seroprevalence of transfusion-transmissible infections among replacement blood donors at a tertiary care centre in Western Uttar Pradesh.

This retrospective, record-based study was conducted in the blood bank of a tertiary care hospital in Western Uttar Pradesh over a six-month period from July 2025 to December 2025. All blood donations during the study period were obtained from replacement donors, as per institutional practice. A total of 9300 blood donors were screened for transfusion-transmissible infections as part of routine blood bank screening. All donated blood units were tested for HIV, hepatitis B virus surface antigen (HBsAg), hepatitis C virus (HCV), syphilis, and malaria using standard serological assays approved by national regulatory authorities. Donors who tested reactive for any one of the screened infections were included in the study, while those who were non-reactive for all infections were excluded from further analysis. Data were collected from blood bank records and analysed using descriptive statistics in Microsoft Excel (Microsoft Corporation, Redmond, WA, USA). Results were expressed as frequencies, percentages, and seroprevalence rates.

During the six-month study period, 9300 replacement blood donors were screened for transfusion-transmissible infections. Of these, 465 donors were found to be seroreactive, yielding an overall seroprevalence of 5.0%. Hepatitis B virus infection was the most common transfusion-transmissible infection, detected in 204 donors (43.87%), with a seroprevalence of 2.19%. This was followed by hepatitis C virus infection in 111 donors (23.87%) and HIV infection in 108 donors (23.23%), with seroprevalence rates of 1.19% and 1.16%, respectively. Syphilis was detected in 33 donors (7.10%), while no donor tested positive for malaria. The distribution and seroprevalence of transfusion-transmissible infections are shown in Table 1 and Figure 1. Age-wise analysis revealed that the majority of seroreactive donors belonged to the 18–30 years age group, accounting for 281 donors (60.4%). This was followed by the 31–40 years age group with 136 donors (29.2%). Fewer seroreactive donors were observed in the 41–50 years age group (36 donors; 7.8%) and in donors aged above 50 years (12 donors; 2.6%). The age-wise distribution is presented in Table 2 and illustrated in Figure 2 Table 1: Distribution of Transfusion- Transmissible Infections among Blood Donors Infection Reactive donors (n) Percentage among reactive (%) Seroprevalence (%) Hepatitis B (HBsAg) 204 43.87 2.19 Hepatitis C (HCV) 111 23.87 1.19 HIV 108 23.23 1.16 Syphilis 33 7.10 0.35 Malaria 0 0 0 Total 465 100 5.00 Table 2: Age-wise Distribution of Seroreactive Donors (n= 465) Age Group (years) Number of Seroreactive Donors Percentage (%) 18-30 281 60.4 31-40 136 29.2 41-50 36 7.8 >50 12 2.6

The present study assessed the pattern of transfusion-transmissible infections among replacement blood donors at a tertiary care centre in Western Uttar Pradesh over a six-month period. The majority of seroreactive donors belonged to the 18–30 years age group. This may reflect higher donation rates and greater exposure to behavioural risk factors among young adults. The overall seroprevalence of TTIs was 5.0%, which is comparable to findings reported from other tertiary care centres in North India. Makroo et al. and Kaur et al. have reported seroprevalence rates ranging from 3% to 6% among blood donors³,⁴. Hepatitis B virus was the predominant transfusion-transmissible infection in the present study, with a seroprevalence of 2.19%. This finding is consistent with several Indian studies that have identified HBV as the leading TTI among blood donors, reflecting its endemicity and limited adult vaccination coverage⁴,⁷. Hepatitis C virus accounted for 1.19% of the total donor population, which is comparable to reports by Pallavi et al. and Arora et al.⁸,⁹. The absence of an effective vaccine and the prolonged asymptomatic phase of infection contribute to the persistent transmission of HCV. The seroprevalence of HIV was 1.16% in the present study. Similar findings have been reported by Gupta et al. and Tiwari et al.7,10, highlighting the continued presence of HIV among blood donor populations despite national control programmes. Syphilis accounted for 0.35% of the total donor population, consistent with other Indian studies reporting a declining yet persistent prevalence.⁹,¹1. The persistence of syphilis among blood donors underscores the importance of screening for bacterial infections in addition to viral TTIs, particularly in regions with high-risk populations. No cases of transfusion-transmitted malaria were detected during the study period, which is in agreement with several recent Indian studies reporting a declining trend in transfusion-transmitted malaria. The exclusive inclusion of replacement donors may have contributed to the observed seroprevalence, as replacement donors are known to have a higher risk of TTIs compared to voluntary donors11. This underscores the importance of promoting voluntary blood donation to improve blood safety. Limitations The study was retrospective and based on blood bank records. Confirmatory testing and risk factor analysis were not performed. The findings may not be generalisable to voluntary donor populations.

The overall seroprevalence of transfusion-transmissible infections among replacement blood donors was 5.0% during the six-month study period. Hepatitis B virus was the most common infection detected. Continuous surveillance, strict donor screening, promotion of voluntary blood donation, and enhanced hepatitis B vaccination coverage are essential to ensure a safe blood supply at tertiary care centres.

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