Hepatitis E Virus in Finland: Epidemiology and Risk in Blood Donors and in the General Population

Mättö, Jaana; Putkuri, Niina; Rimhanen-Finne, Ruska; Laurila, Päivi; Clancy, Jonna; Ihalainen, Jarkko; Ekblom-Kullberg, Susanne

doi:10.3390/pathogens12030484

Cited by 5 publications

(7 citation statements)

References 54 publications

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“…The HEV RNA prevalence of 0.02% observed in the donors in our study is similar to the rates reported in studies of donors in many countries with low/intermediate endemicity, where it is estimated to be 0.02–0.04% [ 19 , 20 , 21 , 22 , 23 ]. However, in several European countries, including Germany, France, and Serbia, HEV RNA positivity in donors was estimated to be significantly higher, at 0.18–0.31% [ 24 ].…”

Section: Discussionsupporting

confidence: 89%

Hepatitis E Virus Infection in Voluntary Blood Donors in the Russian Federation

Potemkin,

Kyuregyan,

Karlsen

et al. 2024

Viruses

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Transfusion-transmitted hepatitis E virus (HEV) infection is an increasing concern in many countries. We investigated the detection rate of HEV viremia in blood donors in Russia. A total of 20,405 regular repetitive voluntary non-renumerated blood donors from two regions (Moscow and Belgorod) were screened for HEV RNA using the cobas® HEV test in mini-pools of six plasma samples. Samples from each reactive pool were tested individually. The average HEV RNA prevalence was 0.024% (95% CI: 0.01–0.05%), or 1 case per 4081 donations. No statistically significant differences in HEV RNA prevalence were observed between the two study regions. The PCR threshold cycle (Ct) values ranged from 25.0 to 40.5 in reactive pools, and from 20.9 to 41.4 in reactive plasma samples when tested individually. The HEV viremic donors had different antibody patterns. Two donor samples were reactive for both anti-HEV IgM and IgG antibodies, one sample was reactive for anti-HEV IgM and negative for anti-HEV IgG, and two samples were seronegative. At follow-up testing 6 months later, on average, four donors available for follow-up had become negative for HEV RNA and positive for anti-HEV IgG. The HEV ORF2 sequence belonging to HEV-3 sub-genotype 3a was obtained from one donor sample. The sequencing failed in the other four samples from viremic donors, presumably due to the low viral load. In conclusion, the HEV RNA detection rate in blood donors in Russia corresponds with data from other European countries, including those that implemented universal donor HEV screening. These data support the implementation of HEV RNA donor screening to reduce the risk of transfusion-transmitted HEV infection in Russia.

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Section: Discussionsupporting

confidence: 89%

Hepatitis E Virus Infection in Voluntary Blood Donors in the Russian Federation

Potemkin,

Kyuregyan,

Karlsen

et al. 2024

Viruses

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“…Considering the residual plasma fraction of the transfused products (a mean of 7.5% for RBCs and 78.5% for plasma), a minimal infectious dose of 2 x 10 4 IU is transfused when the original donation has a viral load above 888 IU/ml for RBCs (58.5%, ca 9,711 infectious products) and above 85 IU/ml for plasma products (88.1%, ca 3,260 infectious products) [ 5 , 16 ]. If we now assume that 60% of these 12,971 infectious products actually lead to infection, and 5% of the transfusion recipients infected have a severe course and 1% a chronic course, as assumed in calculations for Australia and Finland [ 11 , 24 ], this results in 389 cases of severe and 78 cases of chronic infections in the observed 8-year period in Germany.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis E virus infections in German blood donors: results of 8 years of screening, 2015 to 2022

Plümers,

Dreier,

Knabbe

et al. 2024

Eurosurveillance

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Background Awareness of transfusion-transmitted hepatitis E raised in recent years led to the mandatory testing of blood donations in some European countries for hepatitis E virus (HEV) RNA. However, little is known about the epidemiology of HEV infections. Aim To and describe and analyse the epidemiology of HEV infections in blood donors in Germany. Methods Data from routine testing of therapeutic blood products donated between January 2015 and December 2022 at the Uni.Blutspendedienst OWL were analysed at the Institute of Laboratory and Transfusion Medicine, Heart and Diabetes Centre North Rhine-Westphalia. A total of 731,630 allogenic blood donations from 119,610 individual blood donors were tested for HEV RNA in minipools of 96 samples. The HEV RNA-positive donations were analysed for the presence of anti-HEV IgM and IgG. The HEV strains were genotyped and various clinical liver-specific parameters were determined. Results A total of 497 HEV-positive blood donations were identified, resulting in a yearly incidence of 1:1,474, from which 78.4% of the donations were RNA-only positive. Increased alanine aminotransferase activity was determined in 26.6% of HEV RNA-positive donors and was associated with the detection of IgG antibodies (1.2% anti-HEV IgM-positive, 11.9% anti-HEV IgM- and IgG-positive and 8.5% anti-HEV IgG-positive). An average incidence of 0.084–0.083% HEV RNA-positive donations in June and July in all years was observed, and a higher proportion of HEV RNA-positive men compared with women. All isolated HEV sequences corresponded to genotype 3. Conclusion Our results underline the necessity of HEV RNA screening in blood donations.

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“…In 2016, in Sweden, this parameter reached 16% when measured in a group of 500 donors [ 22 ]. In 2023, in Finland, 7.4% of subjects were anti-HEV-positive donors with IgG-class antibodies, and 4.5% HEV-positive donors with IgM-class antibodies out of a group of 1009 donors [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…A complex analysis carried out in eight European countries in 2021–2018 reached a value of 1:3109 [ 9 ]. In Finland, in 2023, HEV RNA was found at 1:6000 [ 11 ], and in Sweden, in 2012, at 1:8000 [ 10 ]. Taking these figures into account, the absence of HEV RNA-positive samples in the examined group of donors looks quite probable and provides reliable evidence that acute HEV infection prevalence in Estonia does not exceed the average level of European countries.…”

Section: Discussionmentioning

confidence: 99%

“…Among the EU countries, the highest prevalence of HEV RNA in donated blood was recorded in France; Germany, the UK, the Netherlands, Belgium, and Sweden have a lesser but substantial HEV prevalence (ranging from 1:844 up to 1:8000 [ 9 , 10 ]). Finland (1:5784) [ 11 ], Poland (1:2109) [ 12 ], and the states of south-eastern Europe [ 13 ] have lesser HEV prevalence than western European countries. In Russia, the anti-HEV IgG antibody detection rates in the general population increase significantly with age: 1.5% in children and adolescents under 20 years old, 4.8% in adults aged between 20 and 59 years old, and 16.7% in people aged 60 years and older [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Prevalence of Hepatitis E Clinical Markers among Donors in Estonia

Kuznetsova,

Moor,

Khanirzayeva

et al. 2023

Viruses

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Hepatitis E virus (HEV) is now considered the most common cause of acute hepatitis worldwide. There are no published data about the prevalence of antibodies to HEV and RNA in donor sera in Estonia, and this precludes planning measures for preventing HEV proliferation through blood transfusion services. Here, were report data from an analysis of 1002 sera on the prevalence of anti-HEV IgG and IgM and the viral RNA. The antibodies were found in 48 donor sera (4.8%); of these, 40 (4%) harbored anti-HEV IgG, 15 (1.5%) contained anti-HEV IgM, and 7 donors had anti-HEV antibodies of both classes simultaneously. HEV RNA was not detected in any blood serum. Statistical associations of infection risk factors (gender, age, travel in the last six months, contact with pigs and/or wild boars in the last six months, consumption of thermally unprocessed/raw pork or boar meat, raw/unfiltered tap water or water from natural sources, unpasteurized farm dairy products, and unwashed berries and/or vegetables) were assessed. None of the listed factors were found to be associated with a higher or lower risk of anti-HEV antibody presence. At the same time, an increasing share of anti-HEV IgG carriers with age was found. The absence of HEV RNA in the analyzed donor plasma samples proves that HEV acute infection prevalence in Estonia does not exceed the average level of European countries. There is no urgent necessity to enter a requirement for a total screening of blood plasma for HEV RNA prevalence in Estonia.

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Hepatitis E Virus in Finland: Epidemiology and Risk in Blood Donors and in the General Population

Cited by 5 publications

References 54 publications

Hepatitis E Virus Infection in Voluntary Blood Donors in the Russian Federation

Hepatitis E Virus Infection in Voluntary Blood Donors in the Russian Federation

Hepatitis E virus infections in German blood donors: results of 8 years of screening, 2015 to 2022

Evaluation of Prevalence of Hepatitis E Clinical Markers among Donors in Estonia

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