Collecting blood just from voluntary repeated blood donors is the wisdom strategy in Vietnam

Sir,

I read with interest the article by Veit et al1 recently. The high prevalence of HBs Ag and anti-HBc antibody in their study group is alarming and indicates the possibility of role of transfusion in transmission of hepatitis B virus (HBV) infection in their community. Blood transfusion is a life-saving component of health care systems, but it can expose the patients to the risk of transmission of infectious agents2. The blood banks’ activities in collecting blood from safe blood donors can help in prevention of residual risk of transmission3. Decreasing the prevalence of HBV and HCV infection in blood donors is related to improvements in donor recruitment and selection, implementation of automation in transfusion services, and a possibly decreasing HBV infection prevalence in the general population4. Shifting from paid and replacement blood donors to volunteer donors should be an important strategy. The authors stated that due to the very high prevalence of anti-HBc antibody (>50%), exclusion of them was not possible. They recommended nucleic acid amplification testing for HBV to be considered for blood donor screening in Vietnam. But performing nucleic acid amplification testing may not be cost-effective in their community. Another strategy which may be considered is to increase the age of HBV vaccination coverage in their community2.