Low transfusion transmission of hepatitis E among 25,637 single‐donation, nucleic acid‐tested blood donors

Harritshøj, Lene Holm; Holm, Dorte Kinggaard; Sækmose, Susanne Gjørup; Jensen, Bitten Aagaard; Hogema, Boris M.; Fischer, Thea Kølsen; Midgley, Sofie; Krog, Jesper Schak; Erikstrup, Christian; Ullum, Henrik

doi:10.1111/trf.13700

Cited by 40 publications

(33 citation statements)

References 34 publications

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“…The prevalence of HEV RNA positive donations was 1:2,331 (0.04%) [16], consistent with data from other northern European countries (Table). Positive donations had a median viral load of 13 IU/mL in a range from unquantifiable to 920 IU/mL [16]. Look-back studies of living recipients found no evidence of TT HEV infections [16].…”

Section: Hepatitis E Virus and Blood Donations In Selected European Csupporting

confidence: 85%

“…Positive donations had a median viral load of 13 IU/mL in a range from unquantifiable to 920 IU/mL [16]. Look-back studies of living recipients found no evidence of TT HEV infections [16]. Based on these data, the Danish Society of Clinical Immunology does not recommend the screening of blood donations for HEV in Denmark [17].…”

Section: Hepatitis E Virus and Blood Donations In Selected European Cmentioning

confidence: 99%

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Hepatitis E and blood donation safety in selected European countries: a shift to screening?

et al. 2017

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The public health implications of hepatitis E virus (HEV) in Europe have changed due to increasing numbers of hepatitis E cases and recent reports of chronic, persistent HEV infections associated with progression to cirrhosis in immunosuppressed patients. The main infectious risk for such immunosuppressed patients is exposure to undercooked infected pork products and blood transfusion. We summarised the epidemiology of HEV infections among blood donors and also outlined any strategies to prevent transfusion-transmitted HEV, in 11 European countries. In response to the threat posed by HEV and related public and political concerns, most of the observed countries determined seroprevalence of HEV in donors and presence of HEV RNA in blood donations. France, Germany, Spain and the United Kingdom (UK) reported cases of transfusion-transmitted HEV. Ireland and the UK have already implemented HEV RNA screening of blood donations; the Netherlands will start in 2017. Germany and France perform screening for HEV RNA in several blood establishments or plasma donations intended for use in high-risk patients respectively and, with Switzerland, are considering implementing selective or universal screening nationwide. In Greece, Portugal, Italy and Spain, the blood authorities are evaluating the situation. Denmark decided not to implement the HEV screening of blood donations.

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Section: Hepatitis E Virus and Blood Donations In Selected European Csupporting

confidence: 85%

Section: Hepatitis E Virus and Blood Donations In Selected European Cmentioning

confidence: 99%

Hepatitis E and blood donation safety in selected European countries: a shift to screening?

et al. 2017

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“…It may also affect the virus ability to transmit and cause infection, since the pORF3 has been shown to be important for viral egress. This might mean that there is lower risk for hepatitis E transmission during the viraemic, although a seronegative state supports a study from Denmark [13]. Seroconversion to anti-HEV may occur after reversion of the ORF3 start codon to AUG.…”

Section: ---------L -----------------------Rp-----v----------------supporting

confidence: 56%

“…It has been shown that blood donors with HEV RNA may be anti-HEV negative for up to 48 days, before seroconversion [8,11]. There are studies showing a low risk of transmission of HEV from HEV RNA-positive blood donations [13], but also that it is cost effective to screen blood products for HEV to minimize hepatitis E posttransfusion [14]. Five European countries have introduced HEV RNA screening of blood products based on this [15].…”

mentioning

confidence: 99%

Hepatitis E Virus Genotype 3 Genomes from RNA-Positive but Serologically Negative Plasma Donors Have CUG as the Start Codon for ORF3

et al. 2018

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Hepatitis E virus (HEV) is a pathogen that causes hepatitis worldwide. Molecular studies have identified HEV RNA in blood products although its significance is not understood. This study was undertaken to characterize HEV genomes in asymptomatic plasma donors from Sweden and Germany lacking anti-HEV. Complete open reading frames (ORFs) were obtained from HEV strains in 5 out of 18 plasma donors who tested positive for HEV RNA. All strains had CUG as the start codon of ORF3, while 147 GenBank strains all had AUG as the start codon (p < 0.0001). This substitution was found in both interrelated and unrelated strains belonging to different phylogenetic clades. The HEV strains from the seronegative plasma donors had no other substitution in common, which may be why the CUG substitution seems to explain the seronegativity.

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“…commun.]. Both Denmark and Sweden have evaluated the incidence of HEV-RNA in their blood donors and do not plan to implement HEV screening [22-24]. In Denmark, TT-HEV was not reported in recipients who received blood components from HEV-infected donors with low VL [22].…”

Section: Overview Of Eu Blood Donor Screening Methods and Strategiesmentioning

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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Low transfusion transmission of hepatitis E among 25,637 single‐donation, nucleic acid‐tested blood donors

Abstract: Despite an HEV RNA prevalence of 0.04% in Danish blood donations, all HEV-positive donations carried low viral loads, and no evidence of TTI was found.

Cited by 40 publications

References 34 publications

Hepatitis E and blood donation safety in selected European countries: a shift to screening?

Hepatitis E and blood donation safety in selected European countries: a shift to screening?

Hepatitis E Virus Genotype 3 Genomes from RNA-Positive but Serologically Negative Plasma Donors Have CUG as the Start Codon for ORF3

Blood Donor Screening for Hepatitis E Virus in the European Union

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