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Hepatitis E virus seroprevalence and molecular study among blood donors in China

Authors

  • Furong Ren,

    1. Beijing Red Cross Blood Center, Beijing, China
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  • Chenyan Zhao,

    1. Division of HIV and Sexual Transmitted Virus Vaccine, National Institutes for Food and Drug Control, Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotech Products, Beijing, China
    2. College of Life Science, Jilin University, Changchun, China
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  • Ling Wang,

    1. Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
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  • Zhuoyan Wang,

    1. Beijing Red Cross Blood Center, Beijing, China
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  • Xiaoyan Gong,

    1. Beijing Red Cross Blood Center, Beijing, China
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  • Meilan Song,

    1. Beijing Red Cross Blood Center, Beijing, China
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  • Hui Zhuang,

    1. Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
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  • Yi Huang,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
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  • Hua Shan,

    1. Division of Blood Transfusion, HIV Specialty Testing Laboratory, Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland
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  • Jingxing Wang,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
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  • Qiang Liu,

    1. Division of HIV and Sexual Transmitted Virus Vaccine, National Institutes for Food and Drug Control, Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotech Products, Beijing, China
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  • Paul Ness,

    1. Division of Blood Transfusion, HIV Specialty Testing Laboratory, Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland
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  • Kenrad E. Nelson,

    1. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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  • Youchun Wang

    Corresponding author
    1. Division of HIV and Sexual Transmitted Virus Vaccine, National Institutes for Food and Drug Control, Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotech Products, Beijing, China
    • Address reprint requests to: Youchun Wang, MD, PhD, Division of HIV and Sexual Transmitted Virus Vaccine, National Institutes for Food and Drug Control, Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotech Products, Beijing 100050, China; e-mail: wangyc@nifdc.org.cn.

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  • This study was supported by 863 projects from National Science and Technology (No. 2006AA02Z453). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Abstract

Background

The risk of hepatitis E virus (HEV) infection from blood transfusion has aroused increasing concern in many countries. The aim of this study was to analyze the potential risk of HEV infection through blood transfusion in China.

Study Design and Methods

Qualified blood donations and donations with isolated alanine aminotransferase (ALT) elevations from five geographically diverse Chinese regions were tested for anti-HEV immunoglobulin (Ig)M and IgG and HEV antigen. The positive samples for anti-HEV IgM and HEV antigen were tested for HEV RNA. HEV open reading frame (ORF)2 partial sequences were analyzed from HEV RNA–positive samples.

Results

The seroprevalence rates of HEV antigen and anti-HEV IgM and IgG among qualified donations were 0.06% (6/10,741), 1.02% (109/10,741), and 27.42% (2945/10,741), respectively. Samples with isolated ALT elevations had higher prevalence of HEV markers, namely, HEV antigen of 0.25% (2/797), anti-HEV IgM of 2.76% (22/797), and anti-HEV IgG of 40.02% (319/797). The HEV antibody prevalence varied significantly by age, sex, and geographic region. All 131 samples that were anti-HEV IgM positive were negative for HEV RNA, whereas four of eight (50%) samples positive for HEV antigen were HEV RNA positive. HEV ORF2 sequences from three of four HEV RNA–positive samples were determined and grouped with Genotype 4.

Conclusion

Qualified donations after routine blood donor screening still carry potential risk for transmitting HEV. HEV antigen screening could be one measure to reduce the risk of HEV transmission by blood transfusion.

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