Retrospective analysis of blood transfusion recipients: evidence for post-transfusion hepatitis E

Vox Sang. 2000;79(2):72-4. doi: 10.1159/000031215.

Abstract

Background and objectives: Of 200 volunteer blood donors we had screened earlier for hepatitis E virus (HEV) RNA, using reverse-transcription polymerase chain reaction, 3 were positive, raising the possibility of transfusion-associated hepatitis E in areas endemic for this virus. This retrospective study was to reassess the extent of post-transfusion hepatitis E among transfusion recipients, investigated in 1982.

Materials and methods: We re-evaluated 56 recipients followed biweekly for 3 months after transfusion. The controls were 51 normal, healthy persons who gave blood at a 2-month interval, as well as 412 blood donors from whom blood was taken once in 1982.

Results: Of the 56 transfusion recipients, 19 were positive for IgG antibodies against HEV (anti-HEV) in the pretransfusion sample. Two of the 37 IgG anti-HEV-negative recipients seroconverted to IgM and IgG anti-HEV 5 and 4 weeks after transfusion, 1 with raised serum alanine aminotransferase levels. None showed symptoms of hepatitis. Attempts to detect HEV RNA in transfused blood, from aliquot units stored at -20 degrees C for over 17 years, were not successful. Of the controls, 17 out of 51 were IgG anti-HEV positive in the initial sample itself. None of the 34 IgG anti-HEV-negative controls seroconverted during the 2-month follow-up. Of the blood donors, 154 out of 412 were IgG anti-HEV positive. None of the 412 donors had circulating IgM anti-HEV antibodies. A significantly higher (p<0.03) proportion of susceptible transfusion recipients were IgM anti-HEV positive as compared with susceptible blood donors.

Conclusion: The results suggest that, in countries where HEV is endemic, the transmission of hepatitis E may be associated with blood transfusion.

MeSH terms

  • Adolescent
  • Adult
  • Alanine Transaminase / blood
  • Antibodies, Viral / blood
  • Blood Donors
  • Female
  • Hepatitis E / genetics
  • Hepatitis E / immunology
  • Hepatitis E / transmission*
  • Hepatitis E virus / genetics
  • Hepatitis E virus / immunology
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin M / blood
  • India / epidemiology
  • Male
  • RNA, Viral / blood
  • Retrospective Studies
  • Reverse Transcriptase Polymerase Chain Reaction
  • Transfusion Reaction*

Substances

  • Antibodies, Viral
  • Immunoglobulin G
  • Immunoglobulin M
  • RNA, Viral
  • Alanine Transaminase