Hepatitis E virus infection in the Irish blood donor population

O’Riordan, Joan; Boland, Fiona; Williams, Pádraig; Donnellan, J. Edward; Hogema, Boris M.; Ijaz, Samreen; Murphy, William G.

doi:10.1111/trf.13757

Cited by 51 publications

(43 citation statements)

References 42 publications

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“…Episodic periods of reactivity with high levels of confirmed cases in January, early February, and mid-April were observed. The HEV RNA prevalence in Irish donations is currently 1:2,778, which is higher than expected from the previous study (anti-HEV IgG positive 5.3% in 2012 and an HEV RNA positivity of 1 in 5,000 donations in the period from December 2013 to June 2014 [30]. …”

Section: Hepatitis E Virus and Blood Donations In Selected European Cmentioning

confidence: 69%

Hepatitis E and blood donation safety in selected European countries: a shift to screening?

et al. 2017

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The public health implications of hepatitis E virus (HEV) in Europe have changed due to increasing numbers of hepatitis E cases and recent reports of chronic, persistent HEV infections associated with progression to cirrhosis in immunosuppressed patients. The main infectious risk for such immunosuppressed patients is exposure to undercooked infected pork products and blood transfusion. We summarised the epidemiology of HEV infections among blood donors and also outlined any strategies to prevent transfusion-transmitted HEV, in 11 European countries. In response to the threat posed by HEV and related public and political concerns, most of the observed countries determined seroprevalence of HEV in donors and presence of HEV RNA in blood donations. France, Germany, Spain and the United Kingdom (UK) reported cases of transfusion-transmitted HEV. Ireland and the UK have already implemented HEV RNA screening of blood donations; the Netherlands will start in 2017. Germany and France perform screening for HEV RNA in several blood establishments or plasma donations intended for use in high-risk patients respectively and, with Switzerland, are considering implementing selective or universal screening nationwide. In Greece, Portugal, Italy and Spain, the blood authorities are evaluating the situation. Denmark decided not to implement the HEV screening of blood donations.

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Section: Hepatitis E Virus and Blood Donations In Selected European Cmentioning

confidence: 69%

Hepatitis E and blood donation safety in selected European countries: a shift to screening?

et al. 2017

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“…Several factors contributed to this decision. Firstly, seroprevalence and RNA incidence amongst Irish blood donors (1: 5,000 donations) [9] and, secondly, the limitations of the Donor Health and Lifestyle Questionnaire in identifying asymptomatic HEV-infected donors. Ethical and legal obligations to protect recipients were also considered.…”

Section: Introductionmentioning

confidence: 99%

Blood Donor Screening for Hepatitis E Virus in the European Union

Boland

Martinez

Pomeroy

et al. 2019

Transfus Med Hemother

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This review article summarises hepatitis E virus (HEV) blood donation screening strategies in effect in the European Union (EU). Since 2012, eight EU countries have implemented HEV screening. Local rates of seroprevalence, RNA incidence, and molecular epidemiology are variable and not usually directly comparable. We report a range of HEV-RNA reactivity rates from 1 in 744 donations (France) to 1 in 8,636 donations (Wales) with an overall EU rate of 1 in 3,109 donations (3.2 million donations screened). HEV genotypes 3c, 3e, and 3f are the most frequently reported subtypes. In these 8 countries, both universal (n = 5) and selective (n = 3) screening policies have been introduced utilising either individual donation (ID; n = 1) or mini-pool (MP; n = 7; MP-6, -16, -24, and -96) testing. We also describe the Irish experience of HEV screening utilising an ID-NAT-based donor screening algorithm which intercepts donations even from those with low-level viraemia; 21 of 56 donors (37.5%) had a viral load (VL) < 100 IU/mL. We performed a MP-24 experiment which may prove useful to colleagues in relation to donor screening and associated blood component transmissibility. Irish results indicate that 59% of donors with a HEV-VL < 450 IU/mL may have screened negative in a MP-24.

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“…Studies conducted among the general population and blood donors in Europe found variable anti‐HEV seroprevalence rates, with important variation even within the same country . Despite the lack of a concerted satisfying definition of the levels of HEV endemicity, also in Europe some areas showing seroprevalence rates approaching to and over 50% have been classified as hyperdendemic .…”

Section: Discussionmentioning

confidence: 99%

“…Because of HEV transfusion‐related risk, prevalence studies have been conducted in blood donors and donations almost worldwide, and the possibility of implementing universal or selective HEV RNA blood donations screening has been suggested . The studies performed in Europe have reported very variable immunoglobulin (Ig) G anti‐HEV prevalence rates ranging from 0.6% to 52.2%, with important variations even within the same countries . This large variability has mainly been attributed to the performance characteristics of anti‐HEV assays used, some geographical‐environmental factors and the cohort under investigation …”

Section: Introductionmentioning

confidence: 99%

Incidence of hepatitis E virus infection among blood donors in a high endemic area of Central Italy

Marcantonio¹,

Pezzotti²,

Bruni³

et al. 2019

Journal of Viral Hepatitis

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Summary In Europe, autochthonous hepatitis E virus (HEV) infection is mainly a foodborne zoonosis, but it is also transmitted by blood transfusion. Despite the numerous prevalence surveys, only a few studies have investigated HEV incidence. We aimed to determine HEV incidence and risk factors among blood donors in a hyperendemic area in Central Italy. Of 296 blood donors who had tested HEV negative in two previous seroprevalence surveys in L'Aquila, 198 agreed to undergo at least another blood sampling for estimating HEV incidence nearly 2 years after the prevalence surveys. Ten newly acquired infections were detected, yielding an overall incidence of 2.1/100 person‐years (95%CI: 1.0‐3.9), with an estimated participant's cumulative probability of becoming HEV infected of 6.5% (95%CI: 3.5‐12.0) at 4 years after enrolment. Seven newly infected blood donors were IgG positive only, two were IgM positive (one also IgG positive) and one was HEV RNA positive only, harbouring subtype 3c. Incident infection was most strongly associated with eating game meat, raw‐dried pork liver sausage and raw‐dried wild boar sausage. None of these exposures was statistically significant, even if eating raw‐dried wild boar sausage approached significance (P = 0.06). The HEV incidence we found was considerable compared with other similar studies. The nearly significant association of incident infection with wild boar and other game meat consumption was in agreement with the 3c subtype isolation in the viremic donor. However, beyond eating habits, also other exposure sources are likely important in hyperendemic areas, where incidence and risk exposure studies need to be undertaken for effectively preventing HEV transmission.

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Hepatitis E virus infection in the Irish blood donor population

Cited by 51 publications

References 42 publications

Hepatitis E and blood donation safety in selected European countries: a shift to screening?

Hepatitis E and blood donation safety in selected European countries: a shift to screening?

Blood Donor Screening for Hepatitis E Virus in the European Union

Incidence of hepatitis E virus infection among blood donors in a high endemic area of Central Italy

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