Abstract
BackgroundIn recent years various studies showed, that hepatitis E virus (HEV) is a growing public health problem in many developed countries. Therefore, HEV infections might bear a transmission risk by blood transfusions. The clinical relevance still requires further investigations. The aim of this study was to provide an overview of acute HEV infections in Upper Austrian blood donors as well as a risk estimation of this transfusion-related infection.Methods and FindingsA total of 58,915 blood donors were tested for HEV RNA using a commercial HEV RT-PCR Kit. 7 of these donors (0.01%) were PCR-positive with normal laboratory parameters in absence of clinical signs of hepatitis. Viral load determined by quantitative real-time PCR showed a HEV nucleic acid concentration of 2,217 293,635 IU/ml. At follow-up testing (2–11 weeks after donation) all blood donors had negative HEV RNA results. Additionally, genotyping was performed by amplification and sequencing of the ORF1 or ORF2 region of the HEV genome. All HEV RNA positive donor samples revealed a genotype 3 isolate. For the antibody screening, anti-HEV IgM and IgG were detected by ELISA. Follow up serological testing revealed that no donor was seropositive for HEV IgM or IgG antibodies at time of donation. Moreover, we verified the prevalence of anti-HEV IgG in 1,203 of the HEV RNA negative tested blood donors. Overall 13.55% showed positive results for anti-HEV IgG.ConclusionsIn the presented study, we investigated HEV infections in blood donations of Upper Austria over 1 year. We concluded that 1 out of 8,416 blood donations is HEV RNA positive. Seroprevalence of anti HEV IgG results in an age-related increase of 13.55%. Therefore, based on this data, we recommend HEV-PCR screening to prevent transmission of hepatitis E virus by transfusion.
Highlights
Hepatitis E Virus (HEV) is a spherical, single-stranded, positive-sense RNA virus without an envelope that belongs to the genus hepevirus in the hepeviridae family [1,2]
We investigated HEV infections in blood donations of Upper Austria over 1 year
In some cases HEV infection can lead to fulminant liver failure and solid organ transplant recipients often develop a chronic HEV infection, which can lead to liver cirrhosis and usually has to be treated with anti-viral therapy [19,20,21]
Summary
Hepatitis E Virus (HEV) is a spherical, single-stranded, positive-sense RNA virus without an envelope that belongs to the genus hepevirus in the hepeviridae family [1,2]. HEV genotypes 1 and 2 are restricted to humans and transmitted from person to person via the faecal-oral route e.g. contaminated water. These genotypes mainly occur in developing regions and are associated with epidemic and sporadic hepatitis E infections. Caution should be taken in risk groups like pregnant women, children, immunocompromised and transplanted recipients, where HEV-infections may take a deleterious path and pose as a rare, but hazardous transfusion-associated disease, with symptoms like jaundice, abdominal pain, hepatomegaly and splenomegaly, elevated transaminases and nausea [1,4,14,15,16,17]. The aim of this study was to provide an overview of acute HEV infections in Upper Austrian blood donors as well as a risk estimation of this transfusion-related infection
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