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An assessment of hepatitis E virus (HEV) in US blood donors and recipients: no detectable HEV RNA in 1939 donors tested and no evidence for HEV transmission to 362 prospectively followed recipients

Authors

  • Chenyu Xu,

    1. Department of Transfusion Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland
    2. National Institute of Diagnostics and Vaccine Development in Infectious Disease, School of Public Health, Xiamen University, Xiamen, Fujian, China
    3. Department of Laboratory Medicine, Center for Cancer and Blood Diseases, Children's National Medical Center
    4. Department of Pediatrics, School of Medicine and Health Sciences, George Washington University, Washington, DC
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  • Richard Y. Wang,

    1. Department of Transfusion Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland
    2. National Institute of Diagnostics and Vaccine Development in Infectious Disease, School of Public Health, Xiamen University, Xiamen, Fujian, China
    3. Department of Laboratory Medicine, Center for Cancer and Blood Diseases, Children's National Medical Center
    4. Department of Pediatrics, School of Medicine and Health Sciences, George Washington University, Washington, DC
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  • Cathy A. Schechterly,

    1. Department of Transfusion Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland
    2. National Institute of Diagnostics and Vaccine Development in Infectious Disease, School of Public Health, Xiamen University, Xiamen, Fujian, China
    3. Department of Laboratory Medicine, Center for Cancer and Blood Diseases, Children's National Medical Center
    4. Department of Pediatrics, School of Medicine and Health Sciences, George Washington University, Washington, DC
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  • Shengxiang Ge,

    1. Department of Transfusion Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland
    2. National Institute of Diagnostics and Vaccine Development in Infectious Disease, School of Public Health, Xiamen University, Xiamen, Fujian, China
    3. Department of Laboratory Medicine, Center for Cancer and Blood Diseases, Children's National Medical Center
    4. Department of Pediatrics, School of Medicine and Health Sciences, George Washington University, Washington, DC
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  • James W. Shih,

    1. Department of Transfusion Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland
    2. National Institute of Diagnostics and Vaccine Development in Infectious Disease, School of Public Health, Xiamen University, Xiamen, Fujian, China
    3. Department of Laboratory Medicine, Center for Cancer and Blood Diseases, Children's National Medical Center
    4. Department of Pediatrics, School of Medicine and Health Sciences, George Washington University, Washington, DC
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  • Ning-Shao Xia,

    1. Department of Transfusion Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland
    2. National Institute of Diagnostics and Vaccine Development in Infectious Disease, School of Public Health, Xiamen University, Xiamen, Fujian, China
    3. Department of Laboratory Medicine, Center for Cancer and Blood Diseases, Children's National Medical Center
    4. Department of Pediatrics, School of Medicine and Health Sciences, George Washington University, Washington, DC
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  • Naomi L.C. Luban,

    1. Department of Transfusion Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland
    2. National Institute of Diagnostics and Vaccine Development in Infectious Disease, School of Public Health, Xiamen University, Xiamen, Fujian, China
    3. Department of Laboratory Medicine, Center for Cancer and Blood Diseases, Children's National Medical Center
    4. Department of Pediatrics, School of Medicine and Health Sciences, George Washington University, Washington, DC
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  • Harvey J. Alter

    Corresponding author
    1. Department of Transfusion Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland
    2. National Institute of Diagnostics and Vaccine Development in Infectious Disease, School of Public Health, Xiamen University, Xiamen, Fujian, China
    3. Department of Laboratory Medicine, Center for Cancer and Blood Diseases, Children's National Medical Center
    4. Department of Pediatrics, School of Medicine and Health Sciences, George Washington University, Washington, DC
    • Address reprint requests to: Harvey J. Alter, MD, MACP, Department of Transfusion Medicine, National Institutes of Health, Building 10, Room 1C-711, 10 Center Drive, Bethesda, MD 20892; e-mail: halter@dtm.cc.nih.gov.

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  • This study was supported by Grant R01 HL67229 from the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) and by the NIH Clinical Center Intramural Program, TRIPS Protocol 01-CC-0231.

Abstract

Background

Hepatitis E virus (HEV) infection has become relevant to blood transfusion practice because isolated cases of blood transmission have been reported and because HEV has been found to cause chronic infection and severe liver disease in immunocompromised patients.

Study Design and Methods

We tested for immunoglobulin (Ig)G and IgM antibodies to the HEV and for HEV RNA in 1939 unselected volunteer US blood donors. Subsequently, we tested the same variables in pre- and serial posttransfusion samples from 362 prospectively followed blood recipients to assess transfusion risk.

Results

IgG anti-HEV seroprevalence in the total 1939 donations was 18.8%: 916 of these donations were made in 2006 at which time the seroprevalence was 21.8% and the remaining 1023 donations were in 2012 when the seroprevalence had decreased to 16.0% (p < 0.01). A significant (p < 0.001) stepwise increase in anti-HEV seroprevalence was seen with increasing age. Eight of 1939 donations (0.4%) tested anti-HEV IgM positive; no donation was HEV RNA positive. Two recipients had an apparent anti-HEV seroconversion, but temporal relationships and linked donor testing showed that these were not transfusion-transmitted HEV infections.

Conclusion

No transfusion-transmitted HEV infections were observed in 362 prospectively followed blood recipients despite an anti-HEV seroprevalence among donations exceeding 16%.

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