Virology, serology, and demography of hepatitis E viremic blood donors in South East England

Tedder, Richard S.; Tettmar, Kate I.; Brailsford, Su; Said, B.; Ushiro-Lumb, Inês; Kitchen, A. D.; Morgan, Dilys; Lattimore, Sam; Tossell, Joanne; Ijaz, Samreen; Hewitt, Patricia

doi:10.1111/trf.13498

Cited by 42 publications

(48 citation statements)

References 22 publications

(31 reference statements)

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“…In conclusion, our data indicate that these HEV IgG/total anti‐HEV assays are useful for examining seroprevalence and associated trends in seroprevalence with an interassay agreement of 84%; however, the disagreement among these assays indicates that there is an associated discordance rate or difference in target detection driving variability as seen by the heteroskedasticity evident among the IgG assays. The case for the IgM assays is worse since no IgM assay evaluated here demonstrated clinical utility in the blood donor population tested, although an IgM response in HEV RNA‐positive blood donors has been well characterized . These data suggest that more reliable information on prevalence may be obtained from using concordant reactive results from multiple assays.…”

Section: Discussionmentioning

confidence: 93%

Disparities in detection of antibodies against hepatitis E virus in US blood donor samples using commercial assays

et al. 2018

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Section: Discussionmentioning

confidence: 93%

Disparities in detection of antibodies against hepatitis E virus in US blood donor samples using commercial assays

et al. 2018

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“…There have been several recent studies investigating the infectivity of HEV-contaminated blood components [1, 12, 27, 29, 44]. The likelihood of transmission is influenced by the donor VL and the residual plasma volume of the blood component, i.e., the infectious dose.…”

Section: Discussionmentioning

confidence: 99%

“…The median infectious dose resulting in HEV infection reported by Dreier et al [29] was 520,000 IU irrespective of recipient immune status. Data on infectious dose from Tedder et al [1, 44] suggest that infection is unlikely to occur at an infectious dose of < 19,000 IU [27]. Applying this information to data generated in an IBTS MP-24 experiment (VL of 130 IU/mL detected in 2/2 replicates), we could infer that a low plasma volume component (e.g., RBC with 13.5 mL plasma) tested in a MP-24 is unlikely to contain an infectious dose (i.e., ∼1,800 IU) sufficient to cause TT-HEV.…”

Section: Discussionmentioning

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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“…Occurrence of HEV viremia in healthy blood donors has been increasingly reported across the globe mainly from Europe [5], and China [1] where genotype 3 and 4 predominate. To explore the possibility of HEV viremia in healthy blood donors of Nepal, we collected blood samples along with demographic data from 581 healthy voluntary blood donors from central blood bank, Kathmandu, Nepal during February-March 2014.…”

mentioning

confidence: 99%

First report of hepatitis E virus viremia in healthy blood donors from Nepal

et al. 2016

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The aim of this study was to detect the prevalence of hepatitis E virus (HEV) in healthy blood donors so as to decipher the maintenance of (HEV) reservoir if any. Five hundred and eighty-one blood samples along with clinical information were collected from central blood bank, Kathmandu between February and March 2014. Samples were tested for hepatitis B virus surface antigen, anti-hepatitis C virus antibodies, anti-hepatitis A virus IgM, HEV antigen, HEV viral load and anti-HEV antibodies (IgM and IgG) by ELISA. Only those samples positive with anti-HEV IgM were tested for HEV RNA by reverse transcriptase nested PCR. Age adjusted prevalence of IgM anti HEV and IgG anti HEV were 3.6 and 8.3 % respectively. No significant difference in Median ALT levels was noted between HEV RNA positive and negative subjects. Sequence analysis of HEV shows all genotype belongs to genotype 1a. Phylogenetic analysis shows the virus has homology of 95 % with strain from India and Nepal outbreak of April 2014. This study sheds light on how inter epidemic reservoirs can be maintained in healthy population with asymptomatic cases. This raises an important question regarding nature of HEV as well as its tendency to circulate in blind sight and also cause periodic outbreaks in endemic setting like Kathmandu.Keywords HEV Á Nepal Á Blood donors Hepatitis E virus (HEV) infection is endemic in Kathmandu Valley the capital of Nepal. Four epidemics have been documented so far during 1973, 1981-1982, 1987 and 2005-2006 and variable numbers of sporadic acute hepatitis E occurred in between [4]. There have been decline in number of acute hepatitis E cases in recent years and hepatitis A infection has outnumbered HEV as an etiology of acute hepatitis in adults [3]. What maintains the virus in the population during low incidence period of acute hepatitis is a matter of debate. There are some evidences that rodents may serve as animal reservoirs for HEV [2].Occurrence of HEV viremia in healthy blood donors has been increasingly reported across the globe mainly from Europe [5], and China [1] where genotype 3 and 4 predominate. To explore the possibility of HEV viremia in healthy blood donors of Nepal, we collected blood samples along with demographic data from 581 healthy voluntary blood donors from central blood bank, Kathmandu, Nepal during February-March 2014. Study subjects constituted 401 men and 180 women volunteer blood donors. Median age of the subjects was 35 years (range 18-55). Elevated ALT levels ([40 IU/L) were noted in 81(13.9 %) with median ALT value of 23 IU/l (range 5-98 IU/L). IgG anti-HEV was detected in 56 samples (9.5 %) and IgM anti-HEV was detected in 27 samples 4.6 %). When adjusted for the age the prevalence of IgM anti HEV and IgG anti HEV were 3.6 and 8.3 % respectively. No significant difference in Median ALT levels was noted between HEV

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Virology, serology, and demography of hepatitis E viremic blood donors in South East England

Cited by 42 publications

References 22 publications

Disparities in detection of antibodies against hepatitis E virus in US blood donor samples using commercial assays

Disparities in detection of antibodies against hepatitis E virus in US blood donor samples using commercial assays

Blood Donor Screening for Hepatitis E Virus in the European Union

First report of hepatitis E virus viremia in healthy blood donors from Nepal

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