An assessment of hepatitisEvirus (HEV) inUSblood donors and recipients: no detectableHEV RNAin 1939 donors tested and no evidence forHEVtransmission to 362 prospectively followed recipients

Abstract

Background Hepatitis E virus (HEV) infection has become relevant to blood transfusion practice because isolated cases of blood transmission have been reported and because HEV has been found to cause chronic infection and severe liver disease in immuno-compromised patients. Study design and Methods We tested for IgG and IgM antibodies to the hepatitis E virus (HEV) and for HEV RNA in 1939 unselected volunteer US blood donors. Subsequently, we tested the same parameters in pre- and serial post-transfusion samples from 362 prospectively followed blood recipients to assess transfusion risk. Results IgG anti-HEV seroprevalence in the total 1939 donations was 18.8%: 916 of these donations were made in 2006 at which time the seroprevalence was 21.8% and the remaining 1023 donations were in 2012 when the seroprevalence had decreased to 16.0% (p<0.01). A significant (P<0.001) stepwise increase in anti-HEV seroprevalence was seen with increasing age. Eight of 1939 donations (0.4%) tested anti-HEV IgM positive; no donation was HEV RNA positive. Two recipients had an apparent anti-HEV seroconversion, but temporal relationships and linked donor testing showed that these were not transfusion transmitted HEV infections. Conclusion No transfusion-transmitted HEV infections were observed in 362 prospectively followed blood recipients despite an anti-HEV seroprevalence among donations exceeding 16%.

Prevalence of hepatitis E virus in Chinese blood donors

“…[1][2][3][4]8 Since the majority of HEV infections are subclinical, 10 17 Scotland 4.7%). 18 The rate of anti-HEV IgG seropositivity in the present study (21.1%) was considerably higher than the rates described above, [11][12][13][14][15][16][17][18] irrespective of ALT concentrations. The anti-HEV IgM seropositivity rates in the present study were 0.9% and 0.0% for donors with and without elevated ALT, respectively.…”

Hepatitis E in Developed Countries: Current Status and Future Perspectives

“…Surprisingly high numbers of blood donors are viremic at the time of donation: Germany 1:1200, The Netherlands 1:2671, England REviEW Dalton, Kamar & Izopet future science group 1:7000 and Sweden 1:7986 [42]. However, in a study of 1939 blood donors in the USA, none were found to be viremic at the time of donation [43]. Donors who have HEV viremia at the time of donation have no symptoms, the liver-function tests are frequently normal and the anti-HEV IgM may be negative.…”

Evaluating the risks posed by hepatitis E virus to blood supply safety

“…Based on concomitant detection of IgM, 2.06% of HEV IgG positive donors had been recently exposed. Comparing only with previous studies using Wantai ELISA (162,179,180,184), the estimate is comparable with those reported from Scotland (4.7%) and New Zealand (4.2%), but lower than those from the USA (18.8%) and France (52.5%). There is considerable debate in relation to the sensitivity and specificity of HEV detection methods (13,224); based on the studies in France and the UK, HEV seroprevalence in this study is measured accurately (162,224).…”

“…The Wantai HEV IgG ELISA manufactured by Beijing Wantai Biological Pharmaceutical Enterprise Co., Ltd is considered to be the most specific and sensitive assay available at present (184). This commercial assay has also been widely used for HEV seroprevalence studies (162,178,184,225), and is therefore preferred for the current study to allow a comparison with these other studies.…”