EASL Clinical Practice Guidelines on hepatitis E virus infection

Dalton, Harry R.; Kamar, Nassim; Baylis, Sally A.; Moradpour, Darius; Wedemeyer, Heiner; Negro, Francesco

doi:10.1016/j.jhep.2018.03.005

Cited by 483 publications

(557 citation statements)

References 155 publications

(224 reference statements)

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“…The European Food Safety Authority (EFSA) has issued advisory recommendations in relation to HEV as a food-borne pathogen, acknowledging that “the level of awareness of HEV risk associated with pig meat products and other reservoirs and sources is low” [2]. The European Association for the Study of the Liver (EASL) has recommended that “immunocompromised individuals and those with chronic liver diseases avoid consumption of undercooked meat (pork, wild boar, and venison) and shellfish” [10]. In addition, EASL also recommends that risk assessment and cost-effectiveness studies inform decisions regarding the screening of blood donors for HEV by NAT.…”

Section: Introductionmentioning

confidence: 99%

Blood Donor Screening for Hepatitis E Virus in the European Union

Boland

Martinez

Pomeroy

et al. 2019

Transfus Med Hemother

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This review article summarises hepatitis E virus (HEV) blood donation screening strategies in effect in the European Union (EU). Since 2012, eight EU countries have implemented HEV screening. Local rates of seroprevalence, RNA incidence, and molecular epidemiology are variable and not usually directly comparable. We report a range of HEV-RNA reactivity rates from 1 in 744 donations (France) to 1 in 8,636 donations (Wales) with an overall EU rate of 1 in 3,109 donations (3.2 million donations screened). HEV genotypes 3c, 3e, and 3f are the most frequently reported subtypes. In these 8 countries, both universal (n = 5) and selective (n = 3) screening policies have been introduced utilising either individual donation (ID; n = 1) or mini-pool (MP; n = 7; MP-6, -16, -24, and -96) testing. We also describe the Irish experience of HEV screening utilising an ID-NAT-based donor screening algorithm which intercepts donations even from those with low-level viraemia; 21 of 56 donors (37.5%) had a viral load (VL) < 100 IU/mL. We performed a MP-24 experiment which may prove useful to colleagues in relation to donor screening and associated blood component transmissibility. Irish results indicate that 59% of donors with a HEV-VL < 450 IU/mL may have screened negative in a MP-24.

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Section: Introductionmentioning

confidence: 99%

Blood Donor Screening for Hepatitis E Virus in the European Union

Boland

Martinez

Pomeroy

et al. 2019

Transfus Med Hemother

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“…HEV is one of the most common causes of viral hepatitis globally, with an estimated 20 million infections and 70,000 deaths attributed to HEV throughout the world in 2005 alone (with similar estimates for subsequent years). ( 1,3 ) It is a nonenveloped virus with a single‐stranded RNA genome belonging to the Herpesviridae family of viruses. There are 4 major genotypes of HEV that can infect humans.…”

Section: Global Epidemiology Of Hev Genotypesmentioning

confidence: 99%

“…Recent guidelines from outside the United States not only provide a framework for the management of HEV but highlight the importance of awareness and recognition among providers in immunocompromised patients who are especially vulnerable to the capacity of HEV to cause chronic infection. ( 1,2 ) Because HEV is thought to be much less prevalent in the United States, it is often a diagnostic afterthought and is a potentially missed diagnosis. However, current estimates of seroprevalence in the United States are widely discrepant, generating concern that HEV is underestimated as a disease entity among transplant and immunocompromised patients.…”

mentioning

confidence: 99%

Hepatitis E Virus Infection in the United States: Current Understanding of the Prevalence and Significance in the Liver Transplant Patient Population and Proposed Diagnostic and Treatment Strategies

2020

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Hepatitis E virus (HEV), of the family Herpesviridae, is a virus that infects nearly 20 million people per year throughout the world. HEV is most commonly transmitted via the fecal-oral route and has long been described as a virus that afflicts only those in resource-poor countries. However, HEV has been detected in numerous animal carriers, various food sources, and even in human blood products in resource-rich regions of the world. HEV is of importance in the transplant patient population because of its ability to cause chronic viral infection in these patients can lead to graft loss and cirrhosis. In this review, we discuss the current knowledge of HEV as it pertains to the liver transplant patient population and discuss diagnosis and treatment of this infection.Liver Transplantation 26 709-717 2020 AASLD.

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“…For example, the transmission of hepatitis E virus by transfusion has been demonstrated, but data to estimate the clinical impact on recipients are limited. There is no vaccine but a treatment is available [34]. Although sensible, finding the best strategy between screening all donors and closely monitoring recipients may not be feasible.…”

Section: Clinical Interpretation Of Ngs Data In Donors and Blood Prodmentioning

confidence: 99%

Viral Metagenomics of Blood Donors and Blood-Derived Products Using Next-Generation Sequencing

Waldvogel-Abramowski

Taleb

Alessandrini

et al. 2019

Transfus Med Hemother

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Transfusion-transmitted infections remain a permanent threat in medicine. It keeps the burden of the past, marked by serious infections transmitted by transfusion, and is constantly threatened by emerging viruses. The global rise of immunosuppression among patients undergoing frequent transfusions exacerbates this problem. Over the past decade, criteria for donor selection have become increasingly more stringent. Although routine nucleic acid testing (NAT) for virus-specific detection has become more sensitive, these safety measures are only valuable for a limited number of select viruses. The scientific approach to this is however changing, with the goal of trying to identify infectious agents in donor units as early as possible to mitigate the risk of a clinically relevant infection. To this end, and in addition to an epidemiological surveillance of the general population, researchers are adopting new methods to discover emerging infectious agents, while simultaneously screening for an extended number of viruses in donors. Next-generation sequencing (NGS) offers the opportunity to explore the entire viral landscape in blood donors, the so-called metagenomics, to investigate severe transfusion reactions of unknown etiology. In the not too distant future, one could imagine this platform being used for routine testing of donated blood products.

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EASL Clinical Practice Guidelines on hepatitis E virus infection

Cited by 483 publications

References 155 publications

Blood Donor Screening for Hepatitis E Virus in the European Union

Blood Donor Screening for Hepatitis E Virus in the European Union

Hepatitis E Virus Infection in the United States: Current Understanding of the Prevalence and Significance in the Liver Transplant Patient Population and Proposed Diagnostic and Treatment Strategies

Viral Metagenomics of Blood Donors and Blood-Derived Products Using Next-Generation Sequencing

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