Blood donor screening practices for the hepatitis B virus (HBV) infections vary from country to country both in terms of the manufacturers of the reagents and the testing methods. Over the past 30 years, the risk of TT-HBV has markedly decreased due to the development of more sensitive hepatitis B surface antigen (HBsAg) tests, the introduction of screening for antibodies against the hepatitis B core antigen (anti-HBc) in some countries, the use of nucleic acid tests (NAT), and improved volunteer donor recruitment processes [1–3]. In recent years, the government of China has taken several measures to improve the safety of the blood supply, which included promulgating a new blood donation law in 1998  and revising standard protocols for donor screening and donation screening processes in 2012 . However, in China, the risk of TT-HBV still remains higher than that of other routinely screened viruses, such as HCV and HIV. When using only HBsAg tests for HBV infection screening, the risk of TT-HBV is high because donors may appear HBsAg-negative but are actually HBV infected, such as those currently in the window period (WP) or at the late stage of infection. This is especially true for the areas with both a high prevalence of HBV and a lack of NAT screening . Also, there is an additional risk associated with chronic OBI. OBI is usually defined (in the blood donor screening context) as an HBV infection without detectable HBsAg, usually presenting itself as anti-HBc positive and, typically, with low levels of HBV DNA. Liang et al. reported that the prevalence of HBsAg in the general population in China fell to 7.2% from 9.8% after the implementation of vaccination against hepatitis B , which has played an important role in decreasing the rate of HBV infection.