Risk of hepatitis-E virus infections among blood donors in a regional blood transfusion centre in western India.
HEV-RNA
RT-PCR
blood donors
hepatitis-E virus
Journal
Transfusion medicine (Oxford, England)
ISSN: 1365-3148
Titre abrégé: Transfus Med
Pays: England
ID NLM: 9301182
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
23
12
2020
accepted:
02
01
2021
pubmed:
20
3
2021
medline:
15
12
2021
entrez:
19
3
2021
Statut:
ppublish
Résumé
Hepatitis-E virus (HEV) is an emerging infectious threat to blood safety. The enormity of the transmission of HEV and its clinical consequence are issues currently under debate. This study aimed to evaluate the prevalence of HEV-RNA in blood donors in western India. We screened 13 050 blood donors for HEV using HEV-RNA screening of 10 mini-pools using RealStar HEV RT-PCR Kit (95% limit of detection (LOD): 4.7 IU/ml). Furthermore, all HEV-RNA-positive donors were investigated for the presence of IgM/IgG antibody along with liver function tests. Of the 13 050 blood donations, 7 (0.53%) were found to be HEV-RNA positive, and the prevalence of HEV nucleic acid testing yield cases among blood donors was 1 in 1864. All seven HEV-RNA-positive samples were tested with anti-HEV IgM and anti-HEV IgG antibodies; this resulted in two (28.5%) positive anti-HEV IgM and two (28.5%) positive anti-HEV IgG antibodies. Hepatic activity was measured, with two of seven HEV-RNA-positive donors demonstrating abnormal serum glutamic oxaloacetic transaminase (SGOT) andserum glutamic pyruvic transaminase (SGPT). Two HEV-RNA-positive blood donors who had abnormal SGOT and SGPT were found to have a high HEV viral load. Furthermore, we were able to follow up two HEV-RNA donors, and both were HEV-RNA positive and had anti-HEV IgM and anti-HEV IgG antibodies; moreover, their liver function tests were also abnormal. One of the HEV-RNA donors with high viral load did show hepatitis-E-like virus on electron microscopy. Our studies indicate that there is a significant risk of blood-borne transmission of HEV. This finding may help to provide a direction towards the safety of blood transfusions in clinical settings in countries like India, which fall under the endemic category for HEV infection.
Sections du résumé
BACKGROUND
BACKGROUND
Hepatitis-E virus (HEV) is an emerging infectious threat to blood safety. The enormity of the transmission of HEV and its clinical consequence are issues currently under debate. This study aimed to evaluate the prevalence of HEV-RNA in blood donors in western India.
MATERIALS AND METHODS
METHODS
We screened 13 050 blood donors for HEV using HEV-RNA screening of 10 mini-pools using RealStar HEV RT-PCR Kit (95% limit of detection (LOD): 4.7 IU/ml). Furthermore, all HEV-RNA-positive donors were investigated for the presence of IgM/IgG antibody along with liver function tests.
RESULTS
RESULTS
Of the 13 050 blood donations, 7 (0.53%) were found to be HEV-RNA positive, and the prevalence of HEV nucleic acid testing yield cases among blood donors was 1 in 1864. All seven HEV-RNA-positive samples were tested with anti-HEV IgM and anti-HEV IgG antibodies; this resulted in two (28.5%) positive anti-HEV IgM and two (28.5%) positive anti-HEV IgG antibodies. Hepatic activity was measured, with two of seven HEV-RNA-positive donors demonstrating abnormal serum glutamic oxaloacetic transaminase (SGOT) andserum glutamic pyruvic transaminase (SGPT). Two HEV-RNA-positive blood donors who had abnormal SGOT and SGPT were found to have a high HEV viral load. Furthermore, we were able to follow up two HEV-RNA donors, and both were HEV-RNA positive and had anti-HEV IgM and anti-HEV IgG antibodies; moreover, their liver function tests were also abnormal. One of the HEV-RNA donors with high viral load did show hepatitis-E-like virus on electron microscopy.
CONCLUSION
CONCLUSIONS
Our studies indicate that there is a significant risk of blood-borne transmission of HEV. This finding may help to provide a direction towards the safety of blood transfusions in clinical settings in countries like India, which fall under the endemic category for HEV infection.
Substances chimiques
Hepatitis Antibodies
0
Immunoglobulin G
0
Immunoglobulin M
0
RNA, Viral
0
Aspartate Aminotransferases
EC 2.6.1.1
Alanine Transaminase
EC 2.6.1.2
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
193-199Informations de copyright
© 2021 British Blood Transfusion Society.
Références
Rein DB, Stevens GA, Theaker J, Wittenborn JS, Wiersma ST. The global burden of hepatitis E virus genotypes 1 and 2 in 2005. Hepatology. 2012;55:988-997.
Kumar S, Subhadra S, Singh B, Panda BK. Hepatitis E virus: the current scenario. Int J Infect Dis. 2013;17:e228-e233.
Denner J, Pischke S, Steinmann E, Blümel J, Glebe D. Why all blood donations should be tested for hepatitis E virus (HEV). BMC Infect Dis. 2019;19:541.
Dreier J, Knabbe C, Vollmer T. Transfusion-transmitted hepatitis E: NAT screening of blood donations and infectious dose. Front Med. 2018;5:5.
Izopet J, Lhomme S, Chapuy-Regaud S, Mansuy JM, Kamar N, Abravanel F. HEV and transfusion-recipient risk. Transfus Clin Biol. 2017;24:176-181.
Arankalle VA, Chobe LP. Hepatitis E virus: can it be transmitted parenterally? J Viral Hepat. 1999;6:161-164.
Tripathy AS, Puranik S, Sharma M, Chakraborty S, Devakate UR. Hepatitis E virus seroprevalence among blood donors in Pune, India. J Med Virol. 2019;91:813-819.
Bajpai M, Gupta E. Transfusion-transmitted hepatitis E: is screening warranted? Indian J Med Microbiol. 2011;29:353-358.
Matsubayashi K, Kang JH, Sakata H, et al. A case of transfusion-transmitted hepatitis E caused by blood from a donor infected with hepatitis E virus via zoonotic food-borne route. Transfusion. 2008;48:1368-1375.
Boxall E, Herborn A, Kochethu G, et al. Transfusion-transmitted hepatitis E in a ‘nonhyperendemic’ country. Transfus Med. 2006;16:79-83.
Colson P, Coze C, Gallian P, Henry M, De Micco P, Tamalet C. Transfusion-associated hepatitis E, France. Emerg Infect Dis. 2007;13:648-649.
Khuroo MS, Kamili S, Yattoo GN. Hepatitis E virus infection may be transmitted through blood transfusions in an endemic area. J Gastroenterol Hepatol. 2004;19:778-784.
Baylis SA, Koc O, Nick S, Blumel J. Widespread distribution of hepatitis E virus in plasma fractionation pools. Vox Sang. 2012;102:182-183.
Cleland A, Smith L, Crossan C, Blatchford O, Dalton HR, Scobie L. Hepatitis E virus in Scottish blood donors. Vox Sang. 2013;105:283-289.
Guo QS, Yan Q, Xiong JH, et al. Prevalence of hepatitis E virus in Chinese blood donors. J Clin Microbiol. 2010;48:317-318.
Ijaz S, Szypulska R, Tettmar KI, Kitchen A, Tedder RS. Detection of hepatitis E virus RNA in plasma mini-pools from blood donors in England. Vox Sang. 2012;102:272.
Thom K, Gilhooly P, McGowan K, et al. Hepatitis E virus (HEV) in Scotland: evidence of recent increase in viral circulation in humans. Euro Surveill. 2018;23:17-174.
Dalton HR, Seghatchian J. Hepatitis E virus: emerging from the shadows in developed countries. Transfus Apher Sci. 2016;55:271-274.
Westhölter D, Hiller J, Denzer U, et al. HEV-positive blood donations represent a relevant infection risk for immunosuppressed recipients. J Hepatol. 2018;69:36-42.
Kotwal A, Singh H, Verma AK, et al. A study of Hepatitis A and E virus seropositivity profile amongst young healthy adults in India. Med J Armed Forces India. 2014;70:225-229.
Vivek R, Chandy GM, Brown DW, Kang G. Seroprevalence of IgG antibodies to hepatitis E in urban and rural southern India. Trans R Soc Trop Med Hyg. 2010;104:307-308.
Nelson KE, Kmush B, Labrique AB. The epidemiology of hepatitis E virus infections in developed countries and among immunocompromised patients. Expert Rev Anti Infect Ther. 2011;9:1133-1148.
Al-Sadeq DW, Majdalawieh AF, Nasrallah GK. Seroprevalence and incidence of hepatitis E virus among blood donors: a review. Rev Med Virol. 2017;27:e1937.
Al-Sadeq DW, Majdalawieh AF, Mesleh AG, et al. Laboratory challenges in the diagnosis of hepatitis E virus. J Med Microbiol. 2018;67:466-480.
Loyrion E, Trouve-Buisson T, Pouzol P, Larrat S, Decaens T, Payen J-F. Hepatitis E virus infection after platelet transfusion in an immunocompetent trauma patient. Emerg Infect Dis. 2017;23:146-147.
Baylis SA, Corman VM, Ong E, Linnen JM, Nübling CM, Blümel J. Hepatitis E viral loads in plasma pools for fractionation. Transfusion. 2016;56:2532-2537.
Gupta BP, Lama TK, Adhikari A, et al. First report of hepatitis E virus viremia in healthy blood donors from Nepal. Virus Dis. 2016;27:324-326.
Zhang L, Jiao S, Yang Z, et al. Prevalence of hepatitis E virus infection among blood donors in mainland China: a meta-analysis. Transfusion. 2017;57:248-257.
Parsa R, Adibzadeh S, Behbahani AB, et al. Detection of hepatitis E virus genotype 1 among blood donors from southwest of Iran. Hepat Mon. 2016;16:e34202.
Kata H, Matsubayashi K, Takeda H. A nationwide survey for hepatitis E virus prevalence in Japanese blood donors with elevated alanine aminotransferase. Transfusion. 2008;48:2568-2576.
Adlhoch C, Kaiser M, Pauli G, Koch J, Meisel H. Indigenous hepatitis E virus infection of a plasma donor in Germany. Vox Sang. 2009;97:303-308.
Domanovic D, Tedder R, Blumel J, et al. Hepatitis E and blood donation safety in selected European countries: a shift to screening? Euro Surveill. 2017;22:30514.
Tendulkar AA, Shah SA, Kelkar RA. A case of Hepatitis E in a blood donor. Asian J Transfus Sci. 2015;9(1):82-84.
Dalton HR, Bendall R, Ijaz S, Banks M. Hepatitis E: an emerging infection in developed countries. Lancet Infect Dis. 2008;8:698-709.
Goel A, Vijay HJ, Katiyar H, Aggarwal R. Prevalence of hepatitis E viraemia among blood donors: a systematic review. Vox Sang. 2020;11:120-132.
Clayson ET, Myint KS, Snitbhan R, et al. Viremia, fecal shedding, and IgM and IgG responses in patients with hepatitis E. J Infect Dis. 1995;172:927-933.
T1 D, Ekermo B, Gaines H, Lesko B, Åkerlind B. The cost-effectiveness of introducing nucleic acid testing to test for hepatitis B, hepatitis C, and human immunodeficiency virus among blood donors in Sweden. Transfusion. 2011;51:421-429.
Chandra T. Implementation of nucleic acid testing in a government blood bank setting in India. Vox Sang. 2013;105:82-87.
Hans R, Marwaha N. Nucleic acid testing-benefits and constraints. Asian J Transfus Sci. 2014;8:2-3.
Mishra KK, Trivedi A, Sosa S, Patel K, Ghosh K. NAT positivity in seronegative voluntary blood donors from western India. Transfus Apher Sci. 2017;56:175-178.
Ghosh K, Mishra KK, Trivedi A, Sosa S, Patel K. Assessment of semi-automated nucleic acid testing programme in a Regional Blood Transfusion Centre. Br J Biomed Sci. 2017;74:42-47.
Ghosh K, Mishra K. Nucleic acid amplification testing in Indian blood banks: a review with perspectives. Indian J Pathol Microbiol. 2017;60:313-318.
Vollmer T, Diekmann J, Johne R, Eberhardt M, Knabbe C, Dreier J. Novel approach for detection of hepatitis E virus infection in German blood donors. J Clin Microbiol. 2012;50:2708-2713.
Arankalle VA, Chobe LP. Retrospective analysis of blood transfusion recipients: evidence for post-transfusion hepatitis E. Vox Sang. 2000;79:72-74.
Boland F, Martinez A, Pomeroy L, O'Flahertya N. Blood donor screening for hepatitis E virus in the European Union. Transfus Med Hemother. 2019;46:95-103.
Fang SY, Han H. Hepatitis E viral infection in solid organ transplant patients. Curr Opin Organ Transplant. 2017;22:351-355.
Gorman JO, Burke Á, Flaherty NO. Hepatitis E virus - key points for the clinical haematologist. Br J Haematol. 2018;181:579-589.
Cooling L. Blood groups in infection and host susceptibility. Clin Microbiol Rev. 2015;28:801-870.
Ren F, Zhao C, Wang L, et al. Hepatitis E virus seroprevalence and molecular study among blood donors in China. Transfusion. 2014;54:910-917.
Gotanda Y, Iwata A, Ohnuma H, et al. Ongoing subclinical infection of hepatitis E virus among blood donors with an elevated alanine aminotransferase level in Japan. J Med Virol. 2007;79:734-742.
Chandra NS, Sharma A, Malhotra B, Rai RR. Dynamics of HEV viremia, fecal shedding and its relationship with transaminases and antibody response in patients with sporadic acute hepatitis E. Virol J. 2010;7:213.
Kamar N, Dalton HR, Abravanel F, Izopet J. Hepatitis E virus infection. Clin Microbiol Rev. 2014;27:116-138.
Wen G-P, Chen C-R, Song X-Y, Tang Z-M, et al. Long-term HEV carriers without antibody seroconversion among eligible immunocompetent blood donors. Emerg Microbes Infect. 2018;7:1.
Goldsmith CS, Miller SE. Modern uses of electron microscopy for detection of viruses. Clin Microbiol Rev. 2009;22:552-563.
Zhang Y, Hung T, Song JD, He JS. Electron microscopy: essentials for viral structure, morphogenesis and rapid diagnosis. Sci China Life Sci. 2013;56:421-430.