Hepatitis E virus in blood components: a prevalence and transmission study in southeast England

Hewitt, Patricia; Ijaz, Samreen; Brailsford, Su; Brett, Rachel; Dicks, Steven; Haywood, Becky; Kennedy, Iain T R; Kitchen, A. D.; Patel, Poorvi; Poh, John; Russell, Katherine; Tettmar, Kate I.; Tossell, Joanne; Ushiro-Lumb, Inês; Tedder, Richard S.

doi:10.1016/s0140-6736(14)61034-5

Cited by 483 publications

(583 citation statements)

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“…In this regard, HEV has been detected in serum and fecal material from rodents, poultry, sheep, cows, dogs, and particularly in pigs (4). Although transmission most often occurs via the fecal-oral route, there have been isolated reports of person-to-person transmission (5), as well as infection via blood transfusion (6,7) and meat consumption (8,9).…”

Section: Introductionmentioning

confidence: 99%

“…The estimated prevalence is 18.6% among those exposed to porcine livestock (4) and 10.4% in HIV-infected individuals (12). In the United States the reported prevalence is 6% (13), while in England the prevalence is only 0.04% among donors (7). The true number of infections is difficult to establish, since subclinical infections are common and probably outnumber clinical infections.…”

Section: Introductionmentioning

confidence: 99%

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Autochthonous acute hepatitis E: an increasingly frequent diagnosis. Clinical-epidemiological analysis of our experience

Ron¹,

Palacios²,

Torres³

et al. 2017

Rev Esp Enferm Dig

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Background: In Europe, acute hepatitis caused by the hepatitis E virus (HEV) traditionally was an infection found in people who had travelled to endemic zones, mainly Asia and Africa. However, a growing number of sporadic autochthonous cases are now being diagnosed in the Western world.Objective: To analyze the cases of acute HEV hepatitis diagnosed in our setting, with the identification of the clinicalepidemiological characteristics. Material and methods:We included the cases of acute HEV hepatitis diagnosed (positive anti-HEV IgM and/or HEV RNA present in serum) between January 2008 and December 2014. Different clinical, epidemiological and evolutive parameters were analyzed.Results: A total of 23 patients were identified, all originating from Spain. Fourteen cases (60.87%) presented jaundice and marked cytolysis at the time of diagnosis (aspartate aminotransferase [AST] 1,106.91 U/l and alanine aminotransferase [ALT] 1,407.04 U/l). Twenty-two cases were regarded as autochthonous, and one patient had travelled to China three months before. The mean time to resolution was 11.2 weeks. Some autoimmune markers were positive in 43.5% of the patients. Two subjects were diagnosed with previous chronic liver disease and were classified as "acuteon-chronic liver failure" (ACLF), one died and the other underwent liver transplantation.Conclusion: Acute HEV hepatitis in our setting is an autochthonous condition that is probably underdiagnosed, manifesting with jaundice and cytolysis. Autoimmune marker positivity is an epiphenomenon, which in some cases complicates the diagnosis.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Autochthonous acute hepatitis E: an increasingly frequent diagnosis. Clinical-epidemiological analysis of our experience

Ron¹,

Palacios²,

Torres³

et al. 2017

Rev Esp Enferm Dig

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“…(3) The estimated detection rate of HEV RNA is one in 2848 blood donations in the United Kingdom and one in 2218 in France. (8,9) Studies using the same assay to estimate the seroprevalence of anti-HEV immunoglobulin G (IgG) among European blood donors have provided figures ranging from 4.7% in Scotland (10) to 52% in southwestern France. (11) We have determined the prevalence of anti-HEV IgG and IgM among 10,569 French blood donors living in all the administrative regions of mainland France and in three overseas areas.…”

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confidence: 99%

A nationwide survey of hepatitis E viral infection in French blood donors

et al. 2016

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Most cases of hepatitis E viral (HEV) infection in developed countries are autochthonous. Nevertheless, the reported seroprevalence of HEV varies greatly depending on the geographical area and the performance of the immunoassay used. We used validated assays to determine the prevalence of anti-HEV immunoglobulin G (IgG) and IgM among 10,569 French blood donors living in mainland France and three overseas areas. Epidemiological information was collected using a specific questionnaire. We found an overall IgG seroprevalence of 22.4% (8%-86.4%) depending on the geographical area (P < 0.001). The presence of anti-HEV IgG was associated with increasing age (P < 0.001) and eating pork meat (P 5 0.03), pork liver sausages (P < 0.001), game meat (P < 0.01), offal (P < 0.001), and oysters (P 5 0.02). Conversely, drinking bottled water was associated with a lower rate of anti-HEV IgG (P 5 0.02). Overall IgM seroprevalence was 1% (0%-4.6%). The frequency of anti-HEV IgM was higher in donors living in a high anti-HEV IgG seroprevalence area (1.9% versus 0.7%, P < 0.001) and in those eating pork liver sausage (1.4% versus 0.7%, P < 0.01), pât e (1% versus 0.4, P 5 0.04), and wild boar (1.3% versus 0.7%, P < 0.01). Conclusion: HEV is endemic in France and hyperendemic in some areas; eating habits alone cannot totally explain the exposure to HEV, and contaminated water could contribute to the epidemiology of HEV infection in France. (HEPATOLOGY 2016;63:1145-1154 H epatitis E virus (HEV) is a single-stranded, positive sense RNA virus that is a member of the Hepeviridae family.(1) Four major genotypes of human HEV are recognized. HEV genotypes 1 and 2 have been found only in humans and are prevalent in developing countries. They are responsible for both sporadic cases and large outbreaks linked to drinking contaminated water. HEV genotypes 3 and 4 are anthropozoonotic and prevalent in developed countries. These HEV genotypes have been detected in a wide range of domestic and wild animals, which are believed to play a major role in the human epidemiology of the virus. (2) HEV genotypes 1 and 2 mainly affect young adults, mostly men, aged 15-30. Almost half of all cases become jaundiced, and pregnant women during the third trimester and patients with underlying chronic liver disease are most at risk of a severe form of hepatitis E.(3) HEV genotypes 3 and 4 mainly affect older men. Most infections are asymptomatic, but patients suffering from chronic liver disease are at risk of developing acute liver failure.(3) Immunosuppressed individuals infected with genotype 3 or 4 may develop a chronic infection that can rapidly progress to cirrhosis. (4) Autochthonous infections are frequently reported in developed countries, particularly in western Europe. (5) The virus can be transmitted by contaminated food, (3) mainly undercooked pig meat, (6) although other modes of contamination have been described. They are often occupational, such as direct exposure to animals or to slaughterhouse meat. The risk of HEV transmission through blood pro...

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“…In einer umfangreichen Studie in England wurden mehr als 220.000 Blutspenden mit der PCR auf HEV-Genom untersucht und 79 virämi-sche Spender identifiziert [218] [201].…”

Section: üBertragbarkeitunclassified

“…Die bekannt gewordenen transfusionsassoziierten Übertragungen von HEV in Europa, die entweder zu (chronischen) Hepatitiden führten oder asymptomatisch verliefen, warfen die Frage auf, ob alle Spenden auf HEV-Virusgenom getestet werden sollten [187,193,[218][219][220]. Inwieweit eine generelle Spendentestung auf HEV-Genom praktikabel und sinnvoll erscheint, sollte auch vor dem Hintergrund der Erkenntnisse diskutiert werden, dass chronische Fälle von Hepatitis E im Prinzip nur bei Immunsupprimierten beobachtet werden und in der Regel eine HEV-Infektion bei Immungesunden asymptomatisch verläuft oder spontan ausheilt.…”

Section: üBertragbarkeitunclassified