Current hepatitis E virus seroprevalence in Swiss blood donors and apparent decline from 1997 to 2016

Abstract

Background and aimHepatitis E virus (HEV) is a virus of emerging importance to transfusion medicine. Studies from several European countries, including Switzerland, have reported high seroprevalence of hepatitis E as a consequence of endemic infections. Published HEV seroprevalence estimates within developed countries vary considerably; primarily due to improved diagnostic assays. The purpose of this study was to investigate the seroprevalence of anti-HEV IgG in Swiss blood donations. Methods: We used the highly sensitive Wantai HEV IgG EIA and assessed regional distribution patterns. We analysed age- and sex-matched archive plasma dating back 20 years from canton Bern to investigate recent changes in HEV seroprevalence levels. Results: On average, 20.4% (95% confidence intervals: 19.1–21.8) of the 3,609 blood samples collected in 2014–16 were anti-HEV IgG positive; however, distinct differences between geographical regions were observed (range: 12.8–33.6%). Seroprevalence increased with age with 30.7% of males and 34.3% of women being positive donors over > 60 years old. Differences between sexes may be attributed to dissimilarities in the average age of this group. Within the specified region of the Bern canton, overall prevalence has declined over two decades from 30.3% in 1997/98 to 27.0% in 2006 and 22.3% in 2015/6. Conclusions: HEV seroprevalence in Switzerland is high, but has declined over the last decades. The result shows that primarily endemic HEV infections occur and that current blood products may pose a risk to vulnerable transfusion recipients. Nucleic acid screening of all blood products for HEV will begin in November 2018.

Blood Donor Screening for Hepatitis E Virus in the European Union

“…As far as the authors are aware at the time of publication, the remaining 12 EU countries have no imminent plans to implement screening. Of note, the Swiss Red Cross implemented universal HEV-RNA screening of blood donors in November 2018 (MP-24 using the Cobas HEV assay®) with a required detection limit of 450 IU/mL in individual donations [25]. …”

Real-life food-safety behavior and incidence of foodborne infections in solid organ transplant recipients

“…Despite a diagnostic bias towards enhanced testing in SOT recipients, we observed an incidence of Campylobacter infections 8‐40 times higher than the general population (19.6‐100 cases per 100 000 persons per year in the general population) . The proportion of HEV reflects the endemic situation in Switzerland (seroprevalence of 20% among blood donors) . In studies addressing the cause of diarrhea in SOT recipients, the proportion of foodborne infections varied, ranging between 1% and 30% for Campylobacter and Salmonella and 4% and 26% for norovirus, although few studies systematically assessed the epidemiology of foodborne infections in SOT recipients .…”

A Special Risk Group for Hepatitis E Infection: The First Record of North Cyprus

“…Prevalence of HEV viremia in blood donors ranges between 1/762 in the Netherlands and 1/9500 people in the United States. Especially immunosuppressed reci pients are under the risk of the HEV infection by contaminated blood products (Niederhauser 2018). In Turkey, the total HEV seroprevalence rate was found to be equal to 4.4% (Aydın et al 2016).…”