Haemovigilance and epidemiological surveillance of transfusion-transmitted infections in Greece, 1996–2023: National donor screening data and recipient investigations - 01/11/26

Doi : 10.1016/j.tracli.2026.10.001

C. Politis ^a,⁎ , 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 Directorate for Epidemiological Surveillance and Intervention, National Public Health Organization Hellenic Centre for Coordinating Haemovigilance, Athens, Greece

^b Hippokrateio General Hospital of Athens, Athens, Greece

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

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

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

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

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

^h Transfusion Service and Clinical Haemostasis, Agios Savvas Oncology Hospital of Athens, 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 Hellenic National Blood Transfusion Center (EKEA), Athens, Greece

^l Molecular Lab Scientific Supervisor, Blood Center, AHEPA University Hospital of Thessaloniki, Athens, Greece

^m Blood Center, AHEPA University Hospital of Thessaloniki, Athens, Greece

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

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

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

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

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

^s Thalassaemia Unit, University Paediatric Clinic, Children's Hospital Hagia Sofia, Athens, Greece

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

^u Thalassaemia Unit, Drakopouleion Blood Centre, Hellenic Red Cross, Athens, Greece

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

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

^x Hospital Blood Service, Hippokrateio General Hospital of Athens, Athens, Greece

^y Directorate of Epidemiological Surveillance and Prevention of Communicable Diseases, National Public Health Organisation, Athens, Greece

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

^aa Internal Medicine and Hepatology, National and Kapodistrian University of Athens, Second Department of Internal Medicine Hippokrateio General Hospital of Athens, Athens, Greece

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

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

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

^⁎ Corresponding author. 3, Garnofski Street, 11742 Athens, Greece. 3, Garnofski Street Athens 11742 Greece

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Sunday 01 November 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.

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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 1321 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.

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Keywords : Haemovigilance, Transfusion–transmitted infections, Nucleic acid testing, Occult hepatitis B infection, Blood donors, Thalassaemia