Prevalence of Antibody to Hepatitis E Virus among Haemodialysis Patients in Taiwan: Possible Infection by Blood Transfusion

Abstract

Background/Aims: A higher prevalence of anti-hepatitis E virus (HEV) in non-endemic viral hepatitis such as in Germany has been reported in our previous study. The aim of this study was to assess the seroepidemiology of HEV among haemodialysis (HD) patients in Shin-Kong Hospital, Taiwan, and to evaluate whether there was an increased risk of infection and exposure to HEV even in an area of endemic viral hepatitis. Methods: Serum samples obtained from 400 Taiwanese patients on chronic HD (group 1), 400 sex- and age-matched healthy subjects (group 2) and hospital patients (group 3) were tested for the IgG anti-HEV. Results: The prevalence of anti-HEV among the HD patients and the healthy controls were 31 and 8.9%, respectively. The difference (22%) was statistically significant (p < 0.01). In comparison, the anti-HEV in hospital patients was 16%. Conclusion: The study indicated a significantly higher risk of HEV infection among patients on chronic HD in endemic regions of viral hepatitis such as Taiwan. Mostly because of anaemia, HD patients usually received packed transfusion (red blood cells) if their haemoglobin was low. It is possible that HEV infection may be transmitted through blood transfusions in an endemic area. In such areas, appropriate strategies should be adopted to prevent the risk of HEV among HD patients.

Non-travel related Hepatitis E virus genotype 3 infections in the Netherlands; A case series 2004 – 2006

“…Three cases were immunocompromised due to malignant disease and one due to usage of immunosuppressive drugs. Two of the cases with malignancies had received multiple blood transfusions during the estimated incubation period which might be the source of their infection, as transmission of HEV via blood has previously been described [32-34]. Trace back of donor blood for these two cases was, however, not considered at the time of this investigation because a relationship with blood donation was thought to be unlikely by the treating physician.…”

Prevalence of Hepatitis E Virus Antibodies in Patients with Chronic Hepatitis B and Chronic Hepatitis C

“…Such a possibility was supported by the observation that anti-HEV antibody was more frequent in transfusion recipients than in non-transfused controls [33] . Several studies concerning HEV epidemiology among chronic hemodialysis patients have been performed [10,30,[34][35][36][37][38] . Except Fabrizi et al [30] , all these studies indicated significantly higher risks of HEV infection in chronic hemodialysis patients.…”

Hepatitis E Virus Infection: A General Review with a Focus on Hemodialysis and Kidney Transplant Patients

“…It is certainly wise to take precautions in highly endemic areas to reduce the risk of HEV infection among HD patients. So far, there have been reports of separate trends in HD units in contrast to the general population [58,59]. As a result, although significant transmission of HEV may occur from sporadic cases or an outbreak in the community to HD centers, risk factors and epidemiological trends might be quite different.…”