Red blood cell transfusion‐transmitted acute hepatitis E in an immunocompetent subject in Europe: a case report

Riveiro‐Barciela, Mar; Sauleda, Sílvia; Quer, Josep; Salvador, Fernando; Gregori, Josep; Pirón, María; Rodríguez‐Frías, Francisco; Buti, Marı́a

doi:10.1111/trf.13876

Cited by 39 publications

(29 citation statements)

References 22 publications

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“…Before such a policy can be implemented, Spanish and EASL HEV guidelines have recommended that studies be carried out to evaluate the prevalence of HEV infection in blood donations across the different areas of influence of blood banks so that HEV screening strategies can be adapted to the relative prevalence of HEV infection in each . In this connection, the prevalence of HEV RNA in blood donations in studies performed in northeast Spain (Catalonia) was 1:3333 and 1:4720, and two cases of HEV transmission via this route have been documented . Our study carried out in south‐central Spain showed a similar prevalence of HEV infection among blood donors, which suggests a similar prevalence of HEV infection nationwide.…”

Section: Discussionmentioning

confidence: 88%

Hepatitis E virus in Spanish donors and the necessity for screening

Rivero‐Juárez

Jarilla‐Fernandez

Frías

et al. 2019

Journal of Viral Hepatitis

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Summary Hepatitis E virus (HEV) represents a major health problem worldwide. As the course of HEV cases is often subclinical, asymptomatic infections could represent an important source of viral spread and infection via routes such as blood donations. Before universal screening for HEV in blood donations can be implemented, studies evaluating the incidence of infection are needed to establish the potential risk of viral transmission. This is a prospective longitudinal study that included blood donors recruited at the Hospital de Ciudad Real Transfusion Service between October 2017 and January 2018. Pools of eight donations were tested for HEV viremia by PCR. Positive pools were individually evaluated following the same procedure. Positive samples were tested for anti‐HEV IgG and IgM. Recipients of blood transfusions obtained from HEV‐positive donors were retrospectively evaluated. The prevalence of HEV was calculated. A total of 11 313 healthy donors were analysed during the study period. Four blood donations from four different donors were HEV RNA‐reactive. The prevalence of HEV infection was 0.035% (95% CI: 0.01%‐0.09%), which meant a ratio of one positive donation per 2828 donations. All donors were negative for anti‐HEV IgM at the time of the donation. Five patients received transfusions from HEV‐positive blood donations, none of them showed an increase in alanine aminotransferase levels after transfusion. In conclusion, our study found a high prevalence of HEV infection in blood donors from south‐central Spain. In view of the prevalence, Spanish blood banks should carefully consider including screening for HEV.

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Section: Discussionmentioning

confidence: 88%

Hepatitis E virus in Spanish donors and the necessity for screening

Rivero‐Juárez

Jarilla‐Fernandez

Frías

et al. 2019

Journal of Viral Hepatitis

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“…The implicated donor had occupational exposure in a sausage factory. Platelets from the same infected donation were transfused to a Hodgkin lymphoma patient who died shortly after transfusion [43]. Selective HEV screening of blood donations is under consideration taking into account logistical challenges.…”

Section: Hepatitis E Virus and Blood Donations In Selected European Cmentioning

confidence: 99%

Hepatitis E and blood donation safety in selected European countries: a shift to screening?

et al. 2017

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The public health implications of hepatitis E virus (HEV) in Europe have changed due to increasing numbers of hepatitis E cases and recent reports of chronic, persistent HEV infections associated with progression to cirrhosis in immunosuppressed patients. The main infectious risk for such immunosuppressed patients is exposure to undercooked infected pork products and blood transfusion. We summarised the epidemiology of HEV infections among blood donors and also outlined any strategies to prevent transfusion-transmitted HEV, in 11 European countries. In response to the threat posed by HEV and related public and political concerns, most of the observed countries determined seroprevalence of HEV in donors and presence of HEV RNA in blood donations. France, Germany, Spain and the United Kingdom (UK) reported cases of transfusion-transmitted HEV. Ireland and the UK have already implemented HEV RNA screening of blood donations; the Netherlands will start in 2017. Germany and France perform screening for HEV RNA in several blood establishments or plasma donations intended for use in high-risk patients respectively and, with Switzerland, are considering implementing selective or universal screening nationwide. In Greece, Portugal, Italy and Spain, the blood authorities are evaluating the situation. Denmark decided not to implement the HEV screening of blood donations.

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“…Blood donor research in south central Spain (October 2017 to March 2018) identified 1 in 1,524 HEV-RNA-positive donations (MP-8 using RT-PCR; 0.06%) with VL ranging from ∼10,000 to 2,000,000 IU/mL [42]. In Spain, 1 confirmed case of TT-HEV infection (GT 3f) has been reported [43]. …”

Section: Overview Of Eu Blood Donor Screening Methods and Strategiesmentioning

confidence: 99%

Blood Donor Screening for Hepatitis E Virus in the European Union

Boland

Martinez

Pomeroy

et al. 2019

Transfus Med Hemother

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This review article summarises hepatitis E virus (HEV) blood donation screening strategies in effect in the European Union (EU). Since 2012, eight EU countries have implemented HEV screening. Local rates of seroprevalence, RNA incidence, and molecular epidemiology are variable and not usually directly comparable. We report a range of HEV-RNA reactivity rates from 1 in 744 donations (France) to 1 in 8,636 donations (Wales) with an overall EU rate of 1 in 3,109 donations (3.2 million donations screened). HEV genotypes 3c, 3e, and 3f are the most frequently reported subtypes. In these 8 countries, both universal (n = 5) and selective (n = 3) screening policies have been introduced utilising either individual donation (ID; n = 1) or mini-pool (MP; n = 7; MP-6, -16, -24, and -96) testing. We also describe the Irish experience of HEV screening utilising an ID-NAT-based donor screening algorithm which intercepts donations even from those with low-level viraemia; 21 of 56 donors (37.5%) had a viral load (VL) < 100 IU/mL. We performed a MP-24 experiment which may prove useful to colleagues in relation to donor screening and associated blood component transmissibility. Irish results indicate that 59% of donors with a HEV-VL < 450 IU/mL may have screened negative in a MP-24.

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Red blood cell transfusion‐transmitted acute hepatitis E in an immunocompetent subject in Europe: a case report

Abstract: Transfusion of RBCs with detectable HEV RNA is a risk factor for acute hepatitis E in immunocompetent patients in Europe.

Cited by 39 publications

References 22 publications

Hepatitis E virus in Spanish donors and the necessity for screening

Hepatitis E virus in Spanish donors and the necessity for screening

Hepatitis E and blood donation safety in selected European countries: a shift to screening?

Blood Donor Screening for Hepatitis E Virus in the European Union

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