A nationwide survey for hepatitis E virus prevalence in Japanese blood donors with elevated alanine aminotransferase

Sakata, Hiromi; Matsubayashi, Keiji; Takeda, Hiromi; Sato, Shin-ichiro; Kato, Toshiaki; Hino, Satoru; Tadokoro, Kenji; Ikeda, Hisami

doi:10.1111/j.1537-2995.2008.01910.x

Cited by 70 publications

(77 citation statements)

References 26 publications

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“…The seroprevalence rates observed in this study (donors with nonelevated ALT, 6%; donors with elevated ALT, 5.88%) are more comparable to rates which have been observed for Switzerland and Japan than to those observed for Germany so far. The seroprevalence rates of anti-HEV IgM have been measured less frequently, but studies in Chinese blood donors revealed a seroprevalence rate of 0.94 to 1.8% (11,21), comparable to 0.5 to 1.6% in Japan (18,20,42) and the 0.5% observed in this study. We also observed a considerably higher seroprevalence rate of 8.08% in donors with elevated ALT levels, according to data obtained by Fukuda et al (3.3%) (18).…”

Section: Discussionmentioning

confidence: 53%

“…Approximately 10% of plasma pools were positive for HEV RNA (sources, North America, Europe, and Southeast Asia) (4), and the rate of individual HEV RNA-positive donors varies from 1:7,986 (Sweden, 0.012%) to 1:4,525 (Germany, 0.022%) (2) to 1:7,040 (United Kingdom, 0.014%) (24). Other studies from Asia revealed hepatitis viremia of 0.07% (China) (21) and 0.3% (Japan) (18) among blood donors and donors with an elevated ALT level of 1.1% (42). In the present study, we even observed a considerably higher rate of 1:1,240 HEV RNA-positive donors (0.08%).…”

Section: Discussionmentioning

confidence: 99%

“…High anti-HEV IgG seroprevalence rates have already been demonstrated among blood donors in developed countries, with considerable differences: Germany, 14.2 to 15.5% (1, 28); Switzerland, 4.1 to 5.4% (27); Denmark, 20.6% (12); Italy, 2.6% (47); Spain, 7.3% (10); France, 3.2 to 16.6% (8,32); England, 10 to 15.8% (5,16); Japan, 3.4% (unselected donors) (44) and 3.2 to 6.6% (preselected study population of donors with elevated ALT levels) (18,42); China, 32.6% (21); and the United States, 18.3% (37). The seroprevalence rates observed in this study (donors with nonelevated ALT, 6%; donors with elevated ALT, 5.88%) are more comparable to rates which have been observed for Switzerland and Japan than to those observed for Germany so far.…”

Section: Discussionmentioning

confidence: 99%

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Novel Approach for Detection of Hepatitis E Virus Infection in German Blood Donors

et al. 2012

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The risk of transfusion-transmitted hepatitis E virus (HEV) infections by contaminated blood products remains unknown. In the present study, we evaluated and compared different nucleic acid amplification technique (NAT) methods for the detection of HEV in blood components. Minipools of a total of 16,125 individual blood donors were screened for the presence of HEV RNA using the highly sensitive RealStar HEV RT-PCR kit, revealing a minimum detection limit of 4.66 IU/ml. Thirteen donors were HEV RNA positive (0.08%), and of these donors, only three already showed reactive IgM antibody titers. The detected HEV strains all belonged to genotype 3 and were most closely related to German HEV strains from wild boars and pigs as well as from human hepatitis E cases. Furthermore, HEV RNA and HEV-specific IgM and IgG titers were determined in 136 blood donors with elevated alanine aminotransferase (ALT) levels and in 200 donors without pathological findings. HEV RNA was not detectable, but 8.08% (elevated ALT) and 0.5% (nonelevated ALT) of donors showed reactive HEV IgM titers. The overall seroprevalence rate of HEV IgG amounted to 5.94% (elevated ALT, 5.88%; nonelevated ALT, 6.0%). The clinical relevance of transfusionassociated hepatitis E infection still requires further investigation. However, in connection with raising concerns regarding blood safety, our NAT method provides a sensitive possibility for HEV testing.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Novel Approach for Detection of Hepatitis E Virus Infection in German Blood Donors

et al. 2012

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“…However, the globally ubiquitous zoonotic HEV strains (genotypes 3 and 4) have more recently been identified as a cause of sporadic hepatitis in medically vulnerable patients and the general population in high-income countries. [4][5][6][7][8][9][10][11][12][13][14] High case-fatality ratios among pregnant women, particularly during the third trimester of pregnancy, remain an almost pathognomonic feature of hepatitis E epidemics caused by HEV genotype 1. [15][16][17][18][19][20][21] There is mounting evidence that hepatitis E is an important contributor to maternal morbidity and mortality in south Asia, even outside of periodic large outbreaks.…”

Section: Introductionmentioning

confidence: 99%

Fetal and Neonatal Health Consequences of Vertically Transmitted Hepatitis E Virus Infection

Krain

Atwell

Nelson

et al. 2014

The American Society of Tropical Medicine and Hygiene

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Abstract. Hepatitis E virus (HEV) infections lead to tens of thousands of deaths annually, mostly in developing countries. Hepatitis E poses a significant threat to the health of expectant mothers, a well-noted epidemiologic feature of the disease, but the contribution of vertically transmitted HEV infection to fetal and neonatal morbidity and mortality has received limited attention. Evidence assembled to date suggests that mother-to-child HEV transmission may be frequent and deleterious to the fetus and newborn in pregnancies affected by hepatitis E. Additional work is required to resolve key questions. (1) What risks do subclinical maternal HEV infections and infections early in pregnancy pose to fetal health and development? (2) Does vertical transmission occur during labor and/or breastfeeding and contribute appreciably to neonatal morbidity and mortality? (3) How do treatment decisions for severely ill mothers affect fetal and neonatal outcomes? (4) Can maternal vaccination effectively prevent vertical transmission of HEV?

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“…For the surveys of HEV prevalence in blood donors, we tested samples of the donors who were disqualified due to high ALT level over 200 IU ⁄ l [4]. Samples of donors with ALT elevation during the 1-year period from April 2003 were collected from all-over Japan and tested for HEV markers: IgM anti-HEV, IgG anti-HEV and HEV RNA.…”

mentioning

confidence: 99%

Prevalence of Hepatitis E virus infection among Japanese blood donors

Ikeda

Matsubayashi

Sakata

et al. 2009

ISBT Science Series

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Hepatitis E virus (HEV) infection has been considered to occur via faecal-oral transmission and is an important public health concern in developing countries, while such HEV transmission had been recognized to be extremely rare in industrialized countries including Japan. Recently, however, increasing cases of hepatitis E are reported in Japan and several cases are described as transfusion-transmission. Many reports from Japan suggest that eating undercooked meat and ⁄ or liver of pigs and other animals is associated with a high risk of acquiring HEV infection. According to the reports by Japanese investigators including ourselves, the HEV RNA-positive donors had no history of recent travel abroad in areas where HEV was hyperendemic [1]. Some isolates from the HEV RNA positive donor samples showed close sequence homology with the isolates from pigs in Japan, indicating that HEV transmission is probably associated with the consumption of undercooked or inadequately cooked pig meat [2]. Thus, HEV is regarded as a zoonotic agent in Japan.Characteristics of hepatitis E in Japan can be summarized as follows. More than 200 cases of hepatitis E have been recently reported [3]. The patients are dominantly middleor high-aged males. The isolated HEVs are genotype 3 and genotype 4 and regarded as indigenous strains in Japan. Genotype 4 viruses may cause more serious symptoms. In about 60% of the cases, their routes of infection remain unknown, although 31% of the cases are confirmed to be zoonotic food-borne. There are several reported cases of transfusion-transmission.So far, we have experienced four cases of transfusiontransmitted hepatitis E (TTHE). In 2004, we reported the first molecularly confirmed case of TTHE. However, infection route of the causative donor was not very clear. To assess the risk of the transfusion-transmission of HEV, we started a series of HEV surveys in blood donors of Hokkaido and nationwide Japan.For the surveys of HEV prevalence in blood donors, we tested samples of the donors who were disqualified due to high ALT level over 200 IU ⁄ l [4]. Samples of donors with ALT elevation during the 1-year period from April 2003 were collected from all-over Japan and tested for HEV markers: IgM anti-HEV, IgG anti-HEV and HEV RNA. As for donors with ALT elevation, Hokkaido was the highest region for all three HEV markers. Also, HEV prevalence was higher in eastern Japan than in western Japan. Among HEV markers of donors with ALT elevation, positive rate of IgG anti-HEV showed clear age-dependency, while there was no age-dependency in IgM anti-HEV or HEV RNA.In the next step, we tested the HEV prevalence of qualified donors. Age-and gender-matched samples of qualified donors were collected from all-over Japan. Again, higher prevalence of HEV IgG was observed in eastern Japan. The positive rates in female donors were lower than that in male donors. There is a clear age-dependency in IgG anti-HEV prevalence in qualified donors. As for IgM anti-HEV, positive samples were too few to draw any conclusion.Meanwhil...

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A nationwide survey for hepatitis E virus prevalence in Japanese blood donors with elevated alanine aminotransferase

Abstract: HEV markers (HEV RNA and anti-HEV) were detected in donors with elevated ALT levels who were widely distributed over Japan. The prevalence and incidence were higher in eastern Japan than in western Japan.

Cited by 70 publications

References 26 publications

Novel Approach for Detection of Hepatitis E Virus Infection in German Blood Donors

Novel Approach for Detection of Hepatitis E Virus Infection in German Blood Donors

Fetal and Neonatal Health Consequences of Vertically Transmitted Hepatitis E Virus Infection

Prevalence of Hepatitis E virus infection among Japanese blood donors

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