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Bienz M, Renaud C, Liu JR, Wong P, Pelletier P. Hepatitis E Virus in the United States and Canada: Is It Time to Consider Blood Donation Screening? Transfus Med Rev 2024; 38:150835. [PMID: 39059853 DOI: 10.1016/j.tmrv.2024.150835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/14/2024] [Accepted: 04/17/2024] [Indexed: 07/28/2024]
Abstract
Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis in the world and can lead to severe complications in immunocompromised individuals. HEV is primarily transmitted through eating pork, which has led to an increased in anti-HEV IgG seropositivity in the general population of Europe in particular. However, it can also be transmitted intravenously, such as through transfusions. The growing evidence of HEV contamination of blood products and documented cases of transmission have given rise to practice changes and blood product screening of HEV in many European countries. This review covers the abundant European literature and focuses on the most recent data pertaining to the prevalence of HEV RNA positivity and IgG seropositivity in the North American general population and in blood products from Canada and the United States. Currently, Health Canada and the Food and Drug Administration do not require testing of HEV in blood products. For this reason, awareness among blood product prescribers about the possibility of HEV transmission through blood products is crucial. However, we also demonstrate that the province of Quebec has a prevalence of anti-HEV and HEV RNA positivity similar to some European countries. In light of this, we believe that HEV RNA blood donation screening be reevaluated with the availability of more cost-effective assays.
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Affiliation(s)
- Marc Bienz
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada; Division of Hematology, Department of Medicine, McGill University, Montreal, Quebec, Canada.
| | - Christian Renaud
- Department of Microbiology, Infectious diseases, and Immunology, Université de Montréal, Montreal, Quebec, Canada; Medical Affairs and Innovation, Héma-Québec, Montreal, Quebec, Canada
| | - Jia Ru Liu
- Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Philip Wong
- Division of Gastroenterology and Hepatology, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Patricia Pelletier
- Division of Hematology, Department of Medicine, McGill University, Montreal, Quebec, Canada
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Plümers R, Dreier J, Knabbe C, Gömer A, Steinmann E, Todt D, Vollmer T. Hepatitis E virus infections in German blood donors: results of 8 years of screening, 2015 to 2022. Euro Surveill 2024; 29:2300665. [PMID: 38873797 PMCID: PMC11177570 DOI: 10.2807/1560-7917.es.2024.29.24.2300665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/29/2024] [Indexed: 06/15/2024] Open
Abstract
BackgroundAwareness of transfusion-transmitted hepatitis E raised in recent years led to the mandatory testing of blood donations in some European countries for hepatitis E virus (HEV) RNA. However, little is known about the epidemiology of HEV infections.AimTo and describe and analyse the epidemiology of HEV infections in blood donors in Germany.MethodsData from routine testing of therapeutic blood products donated between January 2015 and December 2022 at the Uni.Blutspendedienst OWL were analysed at the Institute of Laboratory and Transfusion Medicine, Heart and Diabetes Centre North Rhine-Westphalia. A total of 731,630 allogenic blood donations from 119,610 individual blood donors were tested for HEV RNA in minipools of 96 samples. The HEV RNA-positive donations were analysed for the presence of anti-HEV IgM and IgG. The HEV strains were genotyped and various clinical liver-specific parameters were determined.ResultsA total of 497 HEV-positive blood donations were identified, resulting in a yearly incidence of 1:1,474, from which 78.4% of the donations were RNA-only positive. Increased alanine aminotransferase activity was determined in 26.6% of HEV RNA-positive donors and was associated with the detection of IgG antibodies (1.2% anti-HEV IgM-positive, 11.9% anti-HEV IgM- and IgG-positive and 8.5% anti-HEV IgG-positive). An average incidence of 0.084-0.083% HEV RNA-positive donations in June and July in all years was observed, and a higher proportion of HEV RNA-positive men compared with women. All isolated HEV sequences corresponded to genotype 3.ConclusionOur results underline the necessity of HEV RNA screening in blood donations.
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Affiliation(s)
- Ricarda Plümers
- Institut für Laboratoriums- und Transfusionsmedizin, Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Germany
| | - Jens Dreier
- Institut für Laboratoriums- und Transfusionsmedizin, Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Germany
| | - Cornelius Knabbe
- Institut für Laboratoriums- und Transfusionsmedizin, Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Germany
| | - André Gömer
- Department for Molecular und Medical Medicine, Ruhr University Bochum, Germany
| | - Eike Steinmann
- German Centre for Infection Research (DZIF), External Partner Site, Bochum, Germany
- Department for Molecular und Medical Medicine, Ruhr University Bochum, Germany
| | - Daniel Todt
- European Virus Bioinformatics Center (EVBC), Jena, Germany
- Department for Molecular und Medical Medicine, Ruhr University Bochum, Germany
| | - Tanja Vollmer
- Institut für Laboratoriums- und Transfusionsmedizin, Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Germany
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Potemkin IA, Kyuregyan KK, Karlsen AA, Isaeva OV, Kichatova VS, Lopatukhina MA, Asadi Mobarkhan FA, Zlobina AG, Zheltobriukh AV, Bocharova KA, Belyakova VV, Rassolova SV, Ivanova NV, Solonin SA, Bazhenov AI, Godkov MA, Mikhailov MI. Hepatitis E Virus Infection in Voluntary Blood Donors in the Russian Federation. Viruses 2024; 16:526. [PMID: 38675869 PMCID: PMC11054373 DOI: 10.3390/v16040526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
Transfusion-transmitted hepatitis E virus (HEV) infection is an increasing concern in many countries. We investigated the detection rate of HEV viremia in blood donors in Russia. A total of 20,405 regular repetitive voluntary non-renumerated blood donors from two regions (Moscow and Belgorod) were screened for HEV RNA using the cobas® HEV test in mini-pools of six plasma samples. Samples from each reactive pool were tested individually. The average HEV RNA prevalence was 0.024% (95% CI: 0.01-0.05%), or 1 case per 4081 donations. No statistically significant differences in HEV RNA prevalence were observed between the two study regions. The PCR threshold cycle (Ct) values ranged from 25.0 to 40.5 in reactive pools, and from 20.9 to 41.4 in reactive plasma samples when tested individually. The HEV viremic donors had different antibody patterns. Two donor samples were reactive for both anti-HEV IgM and IgG antibodies, one sample was reactive for anti-HEV IgM and negative for anti-HEV IgG, and two samples were seronegative. At follow-up testing 6 months later, on average, four donors available for follow-up had become negative for HEV RNA and positive for anti-HEV IgG. The HEV ORF2 sequence belonging to HEV-3 sub-genotype 3a was obtained from one donor sample. The sequencing failed in the other four samples from viremic donors, presumably due to the low viral load. In conclusion, the HEV RNA detection rate in blood donors in Russia corresponds with data from other European countries, including those that implemented universal donor HEV screening. These data support the implementation of HEV RNA donor screening to reduce the risk of transfusion-transmitted HEV infection in Russia.
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Affiliation(s)
- Ilya A. Potemkin
- Laboratory of Viral Hepatitis, Mechnikov Research Institute of Vaccines and Sera, 105064 Moscow, Russia; (I.A.P.); (A.A.K.); (O.V.I.); (V.S.K.); (M.A.L.); (F.A.A.M.); (M.I.M.)
- Laboratory of Molecular Epidemiology of Viral Hepatitis, Central Research Institute of Epidemiology, 111123 Moscow, Russia
| | - Karen K. Kyuregyan
- Laboratory of Viral Hepatitis, Mechnikov Research Institute of Vaccines and Sera, 105064 Moscow, Russia; (I.A.P.); (A.A.K.); (O.V.I.); (V.S.K.); (M.A.L.); (F.A.A.M.); (M.I.M.)
- Laboratory of Molecular Epidemiology of Viral Hepatitis, Central Research Institute of Epidemiology, 111123 Moscow, Russia
| | - Anastasia A. Karlsen
- Laboratory of Viral Hepatitis, Mechnikov Research Institute of Vaccines and Sera, 105064 Moscow, Russia; (I.A.P.); (A.A.K.); (O.V.I.); (V.S.K.); (M.A.L.); (F.A.A.M.); (M.I.M.)
- Laboratory of Molecular Epidemiology of Viral Hepatitis, Central Research Institute of Epidemiology, 111123 Moscow, Russia
| | - Olga V. Isaeva
- Laboratory of Viral Hepatitis, Mechnikov Research Institute of Vaccines and Sera, 105064 Moscow, Russia; (I.A.P.); (A.A.K.); (O.V.I.); (V.S.K.); (M.A.L.); (F.A.A.M.); (M.I.M.)
- Laboratory of Molecular Epidemiology of Viral Hepatitis, Central Research Institute of Epidemiology, 111123 Moscow, Russia
| | - Vera S. Kichatova
- Laboratory of Viral Hepatitis, Mechnikov Research Institute of Vaccines and Sera, 105064 Moscow, Russia; (I.A.P.); (A.A.K.); (O.V.I.); (V.S.K.); (M.A.L.); (F.A.A.M.); (M.I.M.)
- Laboratory of Molecular Epidemiology of Viral Hepatitis, Central Research Institute of Epidemiology, 111123 Moscow, Russia
| | - Maria A. Lopatukhina
- Laboratory of Viral Hepatitis, Mechnikov Research Institute of Vaccines and Sera, 105064 Moscow, Russia; (I.A.P.); (A.A.K.); (O.V.I.); (V.S.K.); (M.A.L.); (F.A.A.M.); (M.I.M.)
- Laboratory of Molecular Epidemiology of Viral Hepatitis, Central Research Institute of Epidemiology, 111123 Moscow, Russia
| | - Fedor A. Asadi Mobarkhan
- Laboratory of Viral Hepatitis, Mechnikov Research Institute of Vaccines and Sera, 105064 Moscow, Russia; (I.A.P.); (A.A.K.); (O.V.I.); (V.S.K.); (M.A.L.); (F.A.A.M.); (M.I.M.)
- Laboratory of Molecular Epidemiology of Viral Hepatitis, Central Research Institute of Epidemiology, 111123 Moscow, Russia
| | - Anna G. Zlobina
- Belgorod Blood Center, 308007 Belgorod, Russia; (A.G.Z.); (A.V.Z.)
| | | | - Ksenia A. Bocharova
- Medical Faculty, Belgorod State National Research University, 308015 Belgorod, Russia;
| | - Vera V. Belyakova
- Gavrilov Moscow Blood Center, Moscow Health Department, 125284 Moscow, Russia; (V.V.B.); (S.V.R.); (N.V.I.)
| | - Svetlana V. Rassolova
- Gavrilov Moscow Blood Center, Moscow Health Department, 125284 Moscow, Russia; (V.V.B.); (S.V.R.); (N.V.I.)
| | - Nadezhda V. Ivanova
- Gavrilov Moscow Blood Center, Moscow Health Department, 125284 Moscow, Russia; (V.V.B.); (S.V.R.); (N.V.I.)
| | - Sergey A. Solonin
- Sklifosovsky Research Institute for Emergency Medicine, Moscow Health Department, 129090 Moscow, Russia; (S.A.S.); (A.I.B.); (M.A.G.)
| | - Alexey I. Bazhenov
- Sklifosovsky Research Institute for Emergency Medicine, Moscow Health Department, 129090 Moscow, Russia; (S.A.S.); (A.I.B.); (M.A.G.)
| | - Mikhail A. Godkov
- Sklifosovsky Research Institute for Emergency Medicine, Moscow Health Department, 129090 Moscow, Russia; (S.A.S.); (A.I.B.); (M.A.G.)
| | - Mikhail I. Mikhailov
- Laboratory of Viral Hepatitis, Mechnikov Research Institute of Vaccines and Sera, 105064 Moscow, Russia; (I.A.P.); (A.A.K.); (O.V.I.); (V.S.K.); (M.A.L.); (F.A.A.M.); (M.I.M.)
- Laboratory of Molecular Epidemiology of Viral Hepatitis, Central Research Institute of Epidemiology, 111123 Moscow, Russia
- Medical Faculty, Belgorod State National Research University, 308015 Belgorod, Russia;
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Kuznetsova T, Moor D, Khanirzayeva G, Geller J. Evaluation of Prevalence of Hepatitis E Clinical Markers among Donors in Estonia. Viruses 2023; 15:2118. [PMID: 37896895 PMCID: PMC10612021 DOI: 10.3390/v15102118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
Hepatitis E virus (HEV) is now considered the most common cause of acute hepatitis worldwide. There are no published data about the prevalence of antibodies to HEV and RNA in donor sera in Estonia, and this precludes planning measures for preventing HEV proliferation through blood transfusion services. Here, were report data from an analysis of 1002 sera on the prevalence of anti-HEV IgG and IgM and the viral RNA. The antibodies were found in 48 donor sera (4.8%); of these, 40 (4%) harbored anti-HEV IgG, 15 (1.5%) contained anti-HEV IgM, and 7 donors had anti-HEV antibodies of both classes simultaneously. HEV RNA was not detected in any blood serum. Statistical associations of infection risk factors (gender, age, travel in the last six months, contact with pigs and/or wild boars in the last six months, consumption of thermally unprocessed/raw pork or boar meat, raw/unfiltered tap water or water from natural sources, unpasteurized farm dairy products, and unwashed berries and/or vegetables) were assessed. None of the listed factors were found to be associated with a higher or lower risk of anti-HEV antibody presence. At the same time, an increasing share of anti-HEV IgG carriers with age was found. The absence of HEV RNA in the analyzed donor plasma samples proves that HEV acute infection prevalence in Estonia does not exceed the average level of European countries. There is no urgent necessity to enter a requirement for a total screening of blood plasma for HEV RNA prevalence in Estonia.
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Affiliation(s)
- Tatiana Kuznetsova
- Department of Infectious Disease Research, National Institute for Health Development, 11619 Tallinn, Estonia
| | - Diana Moor
- North Estonia Medical Centre’s Blood Center, North Estonia Medical Centre Foundation, 13419 Tallinn, Estonia; (D.M.); (G.K.)
| | - Gulara Khanirzayeva
- North Estonia Medical Centre’s Blood Center, North Estonia Medical Centre Foundation, 13419 Tallinn, Estonia; (D.M.); (G.K.)
| | - Julia Geller
- Department of Infectious Disease Research, National Institute for Health Development, 11619 Tallinn, Estonia
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