Abstract
Introduction: Hepatitis E virus (HEV) is mainly transmitted through contaminated water supplies which make the virus endemic in developing countries including countries of the Middle East and North Africa (MENA) region. Recent reports suggest potential risk of HEV transmission via blood transfusion particularly in endemic areas. Materials and Methods: Related articles on HEV were collected by searching through the 25 countries of the MENA region using Pubmed and Medline within the past 14 years: January 2000-August 2014. Results: One hundred articles were extracted, of which 25 were not eligible. The articles discussed the seroprevalence of HEV and HEV markers in 12 countries. Eight articles provided data on HEV in blood donors. The seroprevalence of HEV in the general MENA population ranged from 2.0%-37.5% and was higher in males than in females. Prevalence increased with age, but exposure seems to be in early life. Discussion: In the MENA region the role of HEV as an infectious threat to blood safety is under-investigated. More data are needed to quantify the risk of transmission and to assess clinical outcomes. This requires, at least, surveillance screening of donors and recipients for HEV markers using sensitive and specific serological tests. At the present time, serious consideration should be given to selective screening for certain groups of patients (e.g. immunocompromised, pregnant women and others) who commonly require blood transfusion and are at high risk of hepatic failure or chronicity from HEV infection.
Highlights
Hepatitis E virus (HEV) is mainly transmitted through contaminated water supplies which make the virus endemic in developing countries including countries of the Middle East and North Africa (MENA) region
There were eight articles published on HEV in blood donors (Table 2) of which only 2 studies performed HEV-RNA testing to see whether or not the donor was viremic at the time of donation
High HEV-RNA positivity was reported in pediatric patients with acute hepatitis in Egypt (23%), in hepatitis outbreaks in Sudan (20%-27%) in patients with chronic hepatitis C in Turkey (55%) and in pregnant women in UAE (30%)
Summary
Hepatitis E virus (HEV) is mainly transmitted through contaminated water supplies which make the virus endemic in developing countries including countries of the Middle East and North Africa (MENA) region. It is believed that HEV in developed countries is zoonotic and food-borne, mainly associated with eating uncooked or undercooked meat or viscera of deer, boars and pigs or by exposure to infected animals [14,15]. This route of transmission in the MENA is unlikely since pig farming is prohibited in the Islamic culture, as is the case in most countries of the region. HEV is currently the focus of greater attention worldwide and the number of HEV-related articles has more than doubled in the last 10 years
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