Prevalence of hepatitis E virus infection in multiple transfused Brazilian patients with thalassemia and sickle cell disease

Abstract

Hepatitis E virus (HEV) is a leading cause of acute hepatitis worldwide. The virus is acquired by fecal-oral route; however, it can also be transmitted by blood transfusion.The objective of the study was to examine anti-HEV immunoglobulin G and HEV RNA prevalence in multiple transfused patients with thalassemia and sickle cell disease (SCD), and in blood donors. The HEV seroprevalence in the patients was 13% (20% in thalassemics; 7.7% in SCD), and 11% in blood donors. No positive result for HEV RNA was obtained. This is a pioneer study examining HEV circulation in Brazilian patients with hemoglobinopathies. K E Y W O R D S

Recent advances in hepatitis E virus research and the Japanese clinical practice guidelines for hepatitis E virus infection

“…(A‐1) HEV genotypes 3 and 4 may cause chronic infection in immunocompromised hosts, notably in SOT patients 61,90,91,151,246,247 . (B‐2) Attention should be directed toward the extrahepatic manifestations of HEV infection 266–318 . (B‐1)…”

“…Attention should be directed toward the extrahepatic manifestations of HEV infection 266–318 . (B‐1)…”

“….0% or 10.7% in patients from Saudi Arabia with sickle cell anemia or beta thalassemia major, respectively, suggesting the possible transmission of HEV by blood transfusion 280. Thus, multiple transfusions are one of the risk factors for HEV infection [281][282][283][284]. The association of acute HEV infection with glucose-6-phosphate dehydrogenase deficiency reportedly leads to extensive intravascular hemolysis 285,286.…”

Transfusion-transmitted hepatitis E: What we know so far?

“…Red blood cell transfusion was a significant risk factor for HEV seropositivity in patients on hemodialysis in Croatia[ 153 ]. Twenty percent ( n = 8/40) of multiply transfused thalassemia patients were anti-HEV IgG positive compared with 11.0% ( n = 10/91) in blood donors[ 154 ]. In contrast, a study in Iran found anti-HEV antibodies in only 1.67% of patients with thalassemia, suggesting a low rate of TT-HEV in that country[ 155 ].…”

Hepatitis E Virus; An Underestimated Threat for the Viral Hepatitis Elimination Program

“…The transmission of HEV through blood transfusion and organ transplantation has added concerns to public health (22,23). Like other blood-borne pathogens, which are not routinely screened at blood banks, the prevalence of HEV in multi-transfused cohorts is considerable (24,25), which reflects the circulation of viral strains in blood donor pools (26,27). Together with other non-enveloped viruses, HEV is a challenge for pathogen reduction strategies and could impede the safety of plasma therapy (28,29).…”