Detection of Hepatitis E Virus Genotype 1 Among Blood Donors From Southwest of Iran

Abstract

BackgroundInfection with hepatitis E virus (HEV) is endemic in developing countries and reveals significant regional differences. Several studies have reported virus transmission via blood transfusion. To date, however, no cases of HEV RNA detection in blood donors have been reported from Iran.ObjectivesThe aim of this study was to determine the presence of HEV RNA in plasma samples of blood donors referred to a blood transfusion center in Shiraz in the southwest of Iran. The HEV genotypes were also investigated using nucleotide sequencing.Patients and MethodsBlood samples were collected from 700 blood donors who were referred to Fars blood transfusion organization from January to March 2014. Plasma samples were screened for the presence of HEV IgG and IgM antibodies by standard enzyme immunoassay. Samples seroreactive to anti-HEV were further tested for the presence of HEV RNA using nested polymerase chain reaction (PCR) with universal primers for detection of all four HEV genotypes. Positive PCR samples were then subjected to DNA sequencing for further analysis.ResultsFifty (50, 7.1%) out of 700 plasma samples tested positive for anti-HEV antibodies. HEV RNA was detected in 7/50 (12%) of the antibody-positive samples, the majority of which were IgM positive. Sequence analysis of seven isolates of the HEV RNA ORF 2 gene region revealed > 80% similarity with genotype 1.ConclusionsThe analysis indicates that the HEV isolated from blood donors in the southwest of Iran belongs to genotype 1. However, more samples from other geographic regions of Iran are needed to confirm these findings. Because transmission of HEV by administration of blood or blood components is likely to occur, it may be sensible to screen donor blood for HEV to eliminate transfusion-transmitted HEV infection when the recipient is immunocompromised.

Hepatitis E virus seroprevalence among blood donors in Pune, India

“…Our genotyping result goes in parallel with several studies identifying HEV genotype 1 infection among blood donors. Parsa et al have reported HEV RNA positivity in 12% (7 of 50) antibody‐positive samples and sequence analysis of these seven isolates revealed >80% similarity with genotype 1 in blood donors of Iran. Similarly, Zhang et al have reported that the majority of HEV infections in RNA‐positive donors in China were attributed to genotype 1 (19/33 = 58%) and genotype 4 (14/33 = 42%).…”

Seroprevalence and incidence of hepatitis E virus among blood donors: A review

“…Out of these 50 HEV antibody‐positive samples, HEV RNA was detected in only 7 (12%), the majority of which were IgM‐positive. Sequence analysis of these 7 HEV RNA‐positive samples showed that blood donors were infected with HEV‐1 . The importance of this study stems from the reporting of high incidence rate of HEV RNA among blood donors, as well as the identification of HEV‐1, which is recognized as the most pathogenic genotype, especially among pregnant women .…”

“…As expected, and as previously documented in other parts of the world, seroprevalence of HEV increased with age, but exposure seemed to occur in early ages. In a recent study conducted in Southwest Iran in 2016, 50 out of 700 (7.1%) donated blood samples tested positive for HEV antibodies . Out of these 50 HEV antibody‐positive samples, HEV RNA was detected in only 7 (12%), the majority of which were IgM‐positive.…”

Prevalence of Hepatitis E Virus Antibodies Among Blood Donors: A Systematic Review and Meta-Analysis

“…Responsible agencies should consider HEV screening in blood transfusions to avoid its infection and complications, especially in endemic areas where a higher risk is present, considering that every effort to minimize the potential of the transfusion-transmitted disease is valuable (31,33,34).…”