Prevalence of hepatitis E viraemia among blood donors: a systematic review

Abstract

Background Hepatitis E virus (HEV) is usually transmitted by faecal-oral route. Recent reports have documented HEV viraemia in donated blood units and HEV transmission through blood transfusion. This systematic review summarizes the available data on prevalence of HEV viraemia in blood donors.Methods Electronic databases were searched on 17 December 2018 to identify full-text English papers reporting original data on prevalence of HEV RNA in donated blood units. Two authors independently extracted the relevant data, which were pooled using simple aggregation as well as a random-effects metaanalysis; heterogeneity was assessed using the I 2 method.Results In all, 59 data sets from 28 countries were identified. The available data showed marked heterogeneity. Of a total of 2 127 832 units studied, 561 (263Á6 [95% confidence intervals = 242Á7-286Á4] per million units) tested positive for HEV RNA. On random-effects meta-analysis, the pooled prevalence was 60Á9 [6Á7-155Á4] per million units. In the viraemic units, HEV RNA titre varied by nearly one million-fold, and most had genotype 3 HEV. The prevalence was higher in blood units with anti-HEV antibodies or elevated alanine aminotransferase. Only nearly one-fourth of viraemic units had anti-HEV antibodies. ConclusionsThe prevalence of HEV viraemia among healthy blood donors is low, though the available data had limited geographical representation and marked heterogeneity. There is a need for further data on HEV viraemia in blood donors from areas with non-3 HEV genotype preponderance.

Risk of hepatitis‐E virus infections among blood donors in a regional blood transfusion centre in western India

“…Anti‐HEV antibodies serve as a surrogate marker for HEV viraemia. However, in the existing studies, viraemia was equally common in the seropositive and seronegative HEV units; 35 besides that, only a minority of HEV viraemic blood units were seropositive. Therefore, tests for these HEV antibodies are unlikely to be useful for screening donated blood.…”

“…Therefore, tests for these HEV antibodies are unlikely to be useful for screening donated blood. Moreover, it has previously been reported that HEV‐PCR might be a better indicator than ELISA of acute HEV infection, 36 and the identification of HEV‐RNA also has the advantage of a lower likelihood of being affected by genomic variations of the virus 24,35 …”

Platelet Transfusion—Insights from Current Practice to Future Development

“…Hepatitis E virus is one of the non-enveloped viruses with increasing incidence in industrialized countries and may have serious clinical courses with chronic hepatitis and neurological complications, particularly in immunocompromised patients [ 66 ]. Mini pool nucleic acid amplification testing is currently used in blood manufacturing establishments for screening, but it can only detect high viremia [ 67 ].…”

Hepatitis E virus is effectively inactivated in platelet concentrates by ultraviolet C light

“…HEV‐RNA prevalence rates in blood donors who may have acquired the infection by consuming insufficiently cooked meat from infected animals varies widely between different geographical regions [9]. A recent review showed that the pooled prevalence in Europe, North America and Asian countries in high or high‐middle income category ranged from 21·6 to 658·1 per one million donor units [10]. Consequently, HEV transmission through blood transfusion has become an emerging concern in industrialized countries.…”