Abstracts of the 34th International Congress of the International Society of Blood Transfusion, Dubai, United Arab Emirates, September 3-8, 2016.

Abstract

Hepatitis E (HEV) has become the topic in transfusion medicine a few years ago since its occurence is increasing in developed countries. Therefore there is a risk of viral transmission by blood. Blood donors in Croatia are not routinely screened for HEV and there are no data regarding HEV seroprevalence in the general population. We also had no trace-back for HEV. Aims were to estimate the seroprevalence of HEV among voluntary blood donors (VBD) in the Croatian Institute of Transfusion Medicine (CITM). In October and November 2014 a total of 1036 serum samples of VBD were collected. All donors had previously completed the medical questionnaire to verify that they fulfilled the criteria for blood donation and had given informed consent. The study was approved by the Ethics Committee of CITM. There were 913 (88, 1%) males and 123 (11, 9%) females. All of the testing was done according to the producer’s instructions. Samples were primarily tested for total HEV antibodies using a commercial enzyme immunoassay, HEV Ab, Dia.Pro Srl, Milan, Italy (performed on Gemini analyzer). All reactive samples were tested for HEV IgG/IgM by comercial immunoassays, HEV IgG/IgM, Dia.Pro Srl, Milan, Italy (performed on Gemini analyzer). All HEV IgM reactive samples were confirmed by a comercial immunoblot assay, recomLine HEV IgM, Mikrogen, Neuried, Germany (performed on Dynablot Plus analyzer). IgM-positive samples were further tested for the presence of HEV RNA. Viral RNA extraction (QIAamp viral RNA Mini Kit®, Qiagen, Hilden, Germany) was performed from 140 µl of each sera sample. A real time RT-PCR protocol (Jothikumar et al., 2006) for detecting a highly conserved fragment within ORF3 was carried out. The amplification was done in a Rotor-Gene Q machine (Qiagen, Hilden, Germany) by the use of commercially available kits (Rotor-Gene Probe RT-PCR kit, Qiagen, Hilden, Germany) according to the producer’s instructions. 223/1036 (21, 5%) samples were reactive for total HEV antibodies. 210/223 were reactive for HEV IgG and overall anti-HEV IgG seroprevalence was 20, 3%. 45/223 samples were anti-HEV IgM reactive, 18/45 (1, 7%) were confirmed by immunoblot HEV IgM test and HEV RNA was not detected in any of those 18 samples. There is a significant association between age (less and more then 40) and a higher seroprevalence (P<0, 001). The difference between males and females was not significant (P=0, 807). Conclusion: We observed a high HEV IgG seroprevalence of 20, 3% among voluntary blood donors in comparison to the results of previous Croatian data (used Anti-hepatitis E virus ELISA test, Euroimun, Lubeck, Germany) for different population groups: alcohol abusers 8, 9%, war veterans 8, 6%, injecting drug users 6, 1% and healthcare professionals 2, 7%. Results suggest that most autochthonous HEV infections are either asymptomatic or unrecognized. The HEV seroprevalence studies done in developed countries show significant differences, from 0, 3% in Greece to 52, 5% in southwest France, depending on different HEV antibodies detection assays “Wenzel et al, The Journal of Infectious Diseases, 2013”. So, further study will be conducted that compare 3 different anti-HEV IgG/IgM tests.