Abstract
Prevalence of anti-hepatitis E virus (HEV) antibodies is highly variable in developed countries, which seems partly due to differences in assay sensitivity. Using validated sensitive assays, we tested 313 blood donors attending a hospital transfusion unit in central Italy in January and February 2014 for anti-HEV IgG and IgM and HEV RNA. Data on HEV exposure were collected from all donors. Overall anti-HEV IgG prevalence was 49% (153/313). Eating raw dried pig-liver sausage was the only independent predictor of HEV infection (adjusted prevalence rate ratio = 2.14; 95% confidence interval: 1.23-3.74). Three donors were positive for either anti-HEV IgM (n = 2; 0.6%) or HEV RNA (n = 2; 0.6%); they were completely asymptomatic, without alanine aminotransferase (ALT) abnormalities. Of the two HEV RNA-positive donors (both harbouring genotype 3), one was anti-HEV IgG- and IgM-positive, the other was anti-HEV IgG- and IgM-negative. The third donor was positive for anti-HEV IgG and IgM but HEV RNA-negative. HEV infection is therefore hyperendemic among blood donors (80% men 18-64 years-old) from central Italy and associated with local dietary habits. Nearly 1% of donors have acute or recent infection, implying potential transmission to blood recipients. Neither ALT nor anti-HEV IgM testing seems useful to prevent transfusion-transmitted HEV infection.
Highlights
Hepatitis E virus (HEV) is a non-enveloped singlestranded RNA virus of the genus Hepevirus in the Hepeviridae family
In this study we have assessed the prevalence of HEV infection among blood donors in the Abruzzo region in central Italy by using highly sensitive and validated assays, and we have examined its association with putative risk factors
Serum samples were collected from blood donors who agreed to participate in the study
Summary
Hepatitis E virus (HEV) is a non-enveloped singlestranded RNA virus of the genus Hepevirus in the Hepeviridae family. This family contains viruses that infect mammals, including humans, as well as birds and fish. HEV, once thought to be limited to developing countries, has recently been found in developed countries of Europe, North America and Asia-Pacific where human autochthonous cases, probably of zoonotic origin, have become prevalent [1,2]. HEV1 and HEV2 infect only humans and are endemic in developing areas of Asia, Africa and Central and South America, where faecal-oral transmission usually occurs through contaminated water and causes both outbreaks and sporadic cases. Clinical disease mainly affects young adults and is severe and associated with excess mortality in pregnant women and in patients with chronic liver disease [1,2]
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