Haemovigilance and Epidemiological Surveillance of Transfusion-Transmitted Infections in Greece, 1996-2023: National Donor Screening Data and Recipient Investigations - 12/10/26

Doi : 10.1016/j.tracli.2026.10.001

C Politis ^a,⁎ : Prof, S Delicou ^b , S Mellou ^c , K Ventiadi ^d , M Diamantidis ^e , I Lafiatis ^f , M Asariotou ^g , E Grouzi ^h , A Gafou ⁱ , L Politi ^j , K Stamoulis ^k , V Bakaloudi ^l , M Papé ^m , E Zervou ⁿ , G Martinis ^o , M Hatzitaki ^p , P Chalkia ^q , P Damaskos ^r , V Ladis ^s , M Karagiorga ^t , E Vrettou ^u , L Kavalierou ^v , G Bollas ^w , E Nomikou ^x , T Georgakopoulou ^y , G Dougas ^z , M Deutsch ^aa , J Koskinas ^bb , D Paraskevis ^cc , C Richardson ^dd

^a Emeritus Professor of Pathology, National and Kapodistrian University of Athens; Haematologist; Founder and Former Head of the Coordinating Haemovigilance Centre and Surveillance of Transfusion; Honorary Scientific Advisor to the National Public Health Organisation, Athens, Greece

^b Clinical Haematologist; Head of Thalassemia and Sickle Cell Disease Unit; Head of the Expertise Center of Haemoglobinopathies and their Complications, Affiliated Centre of Thalassaemia International Federation (TIF), Hippokrateio General Hospital of Athens, Greece

^c Deputy Head of Hospital Blood Service, Georgios Gennimatas General Hospital of Athens, Greece

^d Head of Thalassaemia Unit, Georgios Gennimatas General Hospital of Athens, Greece

^e Head of Thalassemia and Sickle Cell Disease Unit, Department of Haematology, General Hospital of Larissa, Greece

^f Head of Thalassemia and Sickle Cell Disease Unit, Department of Haematology, Vostaneio General Hospital of Mytilene, Greece

^g Head of the Department of Epidemiological Surveillance of Diseases Transmitted through Substances of Human Origin (SoHOs), National Public Health Organisation, Athens, Greece

^h Consultant of Haematology; Head of Transfusion Service and Clinical Haemostasis, Agios Savvas Oncology Hospital of Athens, Greece

ⁱ Transfusion Service, General and Oncology Hospital Agioi Anargyroi, Athens, Greece

^j Department of Microbial Resistance and Antimicrobial Use, Directorate of Tackling Antimicrobial Resistance and Healthcare-Associated Infections, National Public Health Organisation, Athens, Greece

^k Haematologist; Scientific Director of the Hellenic National Blood Transfusion Center (EKEA); President of the Hellenic Society of Blood Transfusion (ΕΕΜ), Athens, Greece

^l Haematologist; Director of Molecular Lab Scientific Supervisor, Blood Center, AHEPA University Hospital of Thessaloniki, Greece

^m Serology Lab Scientific Supervisor, Blood Center, AHEPA University Hospital of Thessaloniki, Greece

ⁿ Head of Hospital Blood Service, University Hospital of Ioannina; Head of Regional Haemovigilance Centre of Epirus, Ioannina, Greece

^o Head of Hospital Blood Service, University Hospital of Alexandroupolis; Head of Regional Haemovigilance Centre of Thrace, Alexandroupolis, Greece

^p Head of Hospital Blood Service, General Hospital of Larissa; Head of Regional Haemovigilance Centre of Thessaly, Larissa, Greece

^q Haematologist; Head of Hospital Blood Service, Hippokrateio General Hospital of Thessaloniki, Greece

^r Health Sociologist MPH, National Public Health Organisation, Athens, Greece

^s Paediatrician; Thalassaemia Unit, University Paediatric Clinic, Children’s Hospital Hagia Sofia, Athens, Greece

^t Paediatrician; Head of Thalassaemia Unit, National Health System, Children’s Hospital Hagia Sofia, Athens, Greece

^u Paediatrician; Head of Thalassaemia Unit, Drakopouleion Blood Centre, Hellenic Red Cross, Athens, Greece

^v Head of Hospital Blood Service, Sismanogleio – Amalia Fleming Hospital of Athens, Greece

^w Haematologist; Head of Hospital Blood Service, Korgialenio-Benakio Hellenic Red Cross Hospital of Athens, Greece

^x Haematologist; Head of Hospital Blood Service, Hippokrateio General Hospital of Athens, Greece

^y Paediatrician; Infectious Diseases Specialist; Head of the Directorate of Epidemiological Surveillance and Prevention of Communicable Diseases, National Public Health Organisation, Athens, Greece

^z Veterinarian; Epidemiologist; Postdoctoral Fellow, National and Kapodistrian University Athens, Zoonoses Department; Directorate of Epidemiological Surveillance and Prevention of Infectious Diseases, National Public Health Organisation, Athens, Greece

^aa Associate Professor of Internal Medicine and Hepatology, National and Kapodistrian University of Athens; Second Department of Internal Medicine Hippokration General Hospital of Athens, Greece

^bb Emeritus Professor of Hepatology, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece

^cc Professor of Epidemiology and Preventive Medicine, Department of Hygiene, Epidemiology and Medical Statistics, Faculty of Medicine, National and Kapodistrian University of Athens, Greece

^dd Professor of Applied Statistics, Panteion University of Social and Political Sciences, Athens, Greece

^⁎ Corresponding author

Sous presse. Manuscrit accepté. Disponible en ligne depuis le Monday 12 October 2026

Highlights

•	Over 14 million Greek blood donations were screened for infectious markers, 1996-2023
•	NAT found 1,393 serology-negative infectious donations in 2007-2023, mostly HBV
•	Most HIV-positive donors in 2010-2019 were men who have sex with men
•	Fifteen recipient investigations were reported in 2005-2023; one was excluded
•	Emerging pathogens such as WNV and HEV were documented in recipients

Le texte complet de cet article est disponible en PDF.

Abstract

Background: Surveillance of transfusion-transmitted infections (TTIs) supports blood safety, particularly for multi-transfused patients such as those with haemoglobinopathies.

Materials and methods: Retrospective descriptive analysis of aggregated national surveillance data from Greece. We report aggregate infectious-marker positivity values from national surveillance summaries for 1996-2009. We also report NAT yields in 2007-2023, the transmission categories of HIV-positive donors in 2010-2019 and recipient investigations reported to the national haemovigilance system in 2005-2023.

Results: More than 14 million donations were tested in 1996-2023. For 1996-2009, the surveillance summaries reported aggregate positivity of 0.39% for HBsAg, 0.09% for anti-HCV, 0.017% for syphilis and 0.008% for anti-HIV1/2. In 2007-2023, NAT detected 1,393 serology-negative infectious donations among 8,389,862 donations reported as tested (estimated 16.6 per 100,000; 95% CI 15.7-17.5), of which 1,321 were HBV. In 2010-2019, 56.9% of HIV-positive donors were men who have sex with men and 25.3% were heterosexual. Fifteen recipient investigations were reported among 13.6 million issued components; transmission was excluded in one.

Conclusion: In 2007-2023, NAT detected infectious donations that serology missed, mostly HBV. Reported recipient infections were rare but included emerging pathogens. Annual data are needed to assess trends.

Le texte complet de cet article est disponible en PDF.

Keywords : haemovigilance, transfusion-transmitted infections, nucleic acid testing, occult hepatitis B infection, blood donors, thalassaemia