Despite the introduction of more sensitive assays in blood donor screening, our data revealed that the current residual risk of transfusion-transmitted HBV infection is still high (overall 56.53 per 105 py). To improve the safety of blood supplies, we need to continue to educate blood donors and improve donor recruitment and screening strategies. NAT for blood donor screening is needed in China, which may markedly decrease the RR for HBV infections and improve the safety of blood supplies. It is worth considering testing for anti-HBc during blood donor screening in China.