Genotype Distribution and Demographic Characteristics of Hepatitis C Virus Nucleic Acid Testing Yield Cases Among US Blood Donors

Background Hepatitis C virus (HCV) infection rates among US blood donors have been well characterized; however, few studies evaluated HCV genotypes among blood donors. Monitoring trends in disease and demographic patterns contributes to understanding the safety of the blood supply. We examined the demographic characteristics and distribution of HCV genotypes/subgenotypes for nearly a 16-year period among blood donors confirmed positive for HCV RNA but antibody negative (defined as nucleic acid testing [NAT] yield). Methods A retrospective assessment of demographic characteristics and testing data was used to determine temporal trends and geographical distribution of HCV genotypes/subgenotypes among American Red Cross blood donors confirmed positive as HCV-NAT yield. Results From 2003–2018, 343 donors (0.38/100 000 donations; 95% CI, .35–.43) were confirmed positive as HCV-NAT–yield cases. Temporal analysis revealed a significant increase in HCV-NAT–yield cases of 54.1% between 2009 and 2014 (P = .014), followed by a significant decline of 31.4% between 2015 and 2018 (P = .002). Significantly more HCV-NAT–yield cases were detected among first-time donors, non-Hispanic Whites, donors aged 20–29 years, equally likely to be males as females, with the highest frequency in the South (0.52/100 000 donations). Subgenotype 1a (49.6%) was most frequent, followed by 3a (18.7%), 2b (12.5%), 1b (8.5%), and 2a (1.7%). Conclusions Voluntary nonremunerated blood donors are at low risk for HCV infection. Since 2015, the frequency of HCV-NAT–yield cases decreased despite an increase in acute HCV infection in the general population. HCV subgenotypes 1a and 3a continue to remain predominant among US blood donors with recent HCV infection.