Prevalence of hepatitis E virus in Chinese blood donors

Ma, Li; Sun, Pengfei; Lin, Fen; Wang, Hongjie; Xiao, Rong; Dai, Yongyu; Liu, Jianqiang; Qian, Liqiong; Fang, Min; Su, Na; Xiao, Wei; Ye, Shengliang; Li, Changqing

doi:10.1177/0300060514562054

Cited by 17 publications

(14 citation statements)

References 18 publications

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“…In these regions, we report that 3.2% ( Similarly, in a serosurvey of children aged 0-15 during an Ugandan outbreak, IgM positivity was 37.3% (306). In endemic areas, asymptomatic positivity in blood donors varies from 0.5% to 5% (242,244,(307)(308)(309). In this study, finding of 3.2% IgM positivity in blood donors from earthquake-affected regions is consistent with ongoing endemic transmission.…”

Section: Discussionsupporting

confidence: 81%

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

Shrestha¹

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Transfusion is an important field of clinical medicine, responsible for saving the lives of millions of people. However, concerns remain for patients' safety from adverse reactions and transfusion transmissible infections (TTIs). While risks from well-known TTIs (such as human immunodeficiency virus, human T-lymphotrophic virus, hepatitis B virus, hepatitis C virus and Treponema pallidum) have been reduced in developed nations, developing countries struggle to maintain the minimum screening requirements for these infections.

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Section: Discussionsupporting

confidence: 81%

“…However, the causative agent was not identified until 1983 (93). HEV outbreaks continue to occur in many developing countries including Bangladesh, Nepal and Sudan (202,243,244). HEV is considered endemic in many developing countries.…”

Section: Hepatitis E -An Emerging Infectious Diseasementioning

confidence: 99%

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

Shrestha¹

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“…On review of full‐text articles for the remaining 140 citations, 83 did not meet selection criteria. Of the 57 citations selected for final data synthesis , one provided three data sets ; hence, we had a total of 59 data sets from 28 countries (Fig. ).…”

Section: Resultsmentioning

confidence: 99%

“…Four studies (China 3, Japan 1) had assessed HEV viraemia as well as ALT levels in the blood units studied (Table ). The studies from China and Japan used an ALT cut‐off of 40 IU/l and 60 IU/l, respectively, to define normal or elevated ALT.…”

Section: Resultsmentioning

confidence: 99%

Prevalence of hepatitis E viraemia among blood donors: a systematic review

et al. 2020

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Background Hepatitis E virus (HEV) is usually transmitted by faecal-oral route. Recent reports have documented HEV viraemia in donated blood units and HEV transmission through blood transfusion. This systematic review summarizes the available data on prevalence of HEV viraemia in blood donors.Methods Electronic databases were searched on 17 December 2018 to identify full-text English papers reporting original data on prevalence of HEV RNA in donated blood units. Two authors independently extracted the relevant data, which were pooled using simple aggregation as well as a random-effects metaanalysis; heterogeneity was assessed using the I 2 method.Results In all, 59 data sets from 28 countries were identified. The available data showed marked heterogeneity. Of a total of 2 127 832 units studied, 561 (263Á6 [95% confidence intervals = 242Á7-286Á4] per million units) tested positive for HEV RNA. On random-effects meta-analysis, the pooled prevalence was 60Á9 [6Á7-155Á4] per million units. In the viraemic units, HEV RNA titre varied by nearly one million-fold, and most had genotype 3 HEV. The prevalence was higher in blood units with anti-HEV antibodies or elevated alanine aminotransferase. Only nearly one-fourth of viraemic units had anti-HEV antibodies. ConclusionsThe prevalence of HEV viraemia among healthy blood donors is low, though the available data had limited geographical representation and marked heterogeneity. There is a need for further data on HEV viraemia in blood donors from areas with non-3 HEV genotype preponderance.

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“…Blood donation safety has become a major concern since the publication of data from several countries reporting the presence of HEV RNA in blood components. [3][4][5]11 The importance of acute hepatitis E is related to the risk of fulminant hepatitis, acute-on-chronic liver failure, and, mainly, the risk of chronic infection in immunosuppressed patients, with development of liver cirrhosis. 12,13 A retrospective study carried out in England showed that the risk of HEV transmission from blood donations differed according to the blood component transfused.…”

Section: Discussionmentioning

confidence: 99%

Thrombotic thrombocytopenic purpura relapse induced by acute hepatitis E transmitted by cryosupernatant plasma and successfully controlled with ribavirin

et al. 2018

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BACKGROUND Hepatitis E virus (HEV) can be transmitted by transfusion of any type of blood component, but there are few data on the potential risk of transmitting this virus and the associated complications. We provide evidence that HEV can be transmitted by cryosupernatant plasma, and that HEV infection can act as a trigger for thrombotic thrombocytopenic purpura (TTP). STUDY DESIGN AND METHODS A patient with a history of TTP treated with plasmapheresis 2 months previously developed jaundice and a TTP exacerbation with purpura, thrombocytopenia, schistocytes, and undetectable ADAMTS‐13 activity. He was diagnosed with acute hepatitis E and treated with ribavirin. TTP remitted with remission of HEV infection. RESULTS Traceback to determine the source of the infection showed that 1 cryosupernatant plasma among the 99 different blood components used for the patient's last plasmapheresis was positive for HEV RNA, with an estimated viral load of 5000 to 10,000 IU/mL. Phylogenetic analysis proved the transfusion‐transmitted route of acute hepatitis E. CONCLUSION In a patient with TTP, acute HEV infection transmitted by cryosupernatant plasma may trigger exacerbation of TTP, which can be controlled on remission of HEV infection with ribavirin.

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Prevalence of hepatitis E virus in Chinese blood donors

Cited by 17 publications

References 18 publications

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

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

Prevalence of hepatitis E viraemia among blood donors: a systematic review

Thrombotic thrombocytopenic purpura relapse induced by acute hepatitis E transmitted by cryosupernatant plasma and successfully controlled with ribavirin

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