1887
  1. Home
  2. Eurosurveillance
  3. Volume 21, Issue 35, 01/Sep/2016
  4. Article
Research article Open Access
Like 0
Download

Abstract

Asymptomatic hepatitis E virus (HEV) infections have been found in blood donors from various European countries, but the natural course is rarely specified. Here, we compared the progression of HEV viraemia, serostatus and liver-specific enzymes in 10 blood donors with clinically asymptomatic genotype 3 HEV infection, measuring HEV RNA concentrations, plasma concentrations of alanine/aspartate aminotransferase, glutamate dehydrogenase and bilirubin and anti-HEV IgA, IgM and IgG antibodies. RNA concentrations ranged from 77.2 to 2.19×105 IU/mL, with viraemia lasting from less than 10 to 52 days. Donors showed a typical progression of a recent HEV infection but differed in the first detection of anti-HEV IgA, IgM and IgG and seropositivity of the antibody classes. The diagnostic window between HEV RNA detection and first occurrence of anti-HEV antibodies ranged from eight to 48 days, depending on the serological assay used. The progression of laboratory parameters of asymptomatic HEV infection was largely comparable to the progression of symptomatic HEV infection, but only four of 10 donors showed elevated liver-specific parameters. Our results help elucidate the risk of transfusion-associated HEV infection and provide a basis for development of screening strategies. The diagnostic window illustrates that infectious blood donors can be efficiently identified only by RNA screening.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2016.21.35.30332
2016-09-01
2024-12-26
/content/10.2807/1560-7917.ES.2016.21.35.30332
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/21/35/eurosurv-21-30332-5.html?itemId=/content/10.2807/1560-7917.ES.2016.21.35.30332&mimeType=html&fmt=ahah

References

  1. 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(4):303-8.  https://doi.org/10.1111/j.1423-0410.2009.01211.x  PMID: 19555366 
  2. Purcell RH, Emerson SU. Hepatitis E: an emerging awareness of an old disease. J Hepatol. 2008;48(3):494-503.  https://doi.org/10.1016/j.jhep.2007.12.008  PMID: 18192058 
  3. Guthmann JP, Klovstad H, Boccia D, Hamid N, Pinoges L, Nizou JY, et al. A large outbreak of hepatitis E among a displaced population in Darfur, Sudan, 2004: the role of water treatment methods. Clin Infect Dis. 2006;42(12):1685-91.  https://doi.org/10.1086/504321  PMID: 16705572 
  4. Dalton HR, Kamar N, Izopet J. Hepatitis E in developed countries: current status and future perspectives. Future Microbiol. 2014;9(12):1361-72.  https://doi.org/10.2217/fmb.14.89  PMID: 25517900 
  5. Rutjes SA, Lodder WJ, Lodder-Verschoor F, van den Berg HH, Vennema H, Duizer E, et al. Sources of hepatitis E virus genotype 3 in The Netherlands. Emerg Infect Dis. 2009;15(3):381-7.  https://doi.org/10.3201/eid1503.071472  PMID: 19239749 
  6. Krumbholz A, Mohn U, Lange J, Motz M, Wenzel JJ, Jilg W, et al. Prevalence of hepatitis E virus-specific antibodies in humans with occupational exposure to pigs. Med Microbiol Immunol (Berl). 2012;201(2):239-44.  https://doi.org/10.1007/s00430-011-0210-5  PMID: 21773797 
  7. Matsuda H, Okada K, Takahashi K, Mishiro S. Severe hepatitis E virus infection after ingestion of uncooked liver from a wild boar. J Infect Dis. 2003;188(6):944.  https://doi.org/10.1086/378074  PMID: 12964128 
  8. Kamar N, Dalton HR, Abravanel F, Izopet J. Hepatitis E virus infection. Clin Microbiol Rev. 2014;27(1):116-38.  https://doi.org/10.1128/CMR.00057-13  PMID: 24396139 
  9. Boccia D, Guthmann JP, Klovstad H, Hamid N, Tatay M, Ciglenecki I, et al. High mortality associated with an outbreak of hepatitis E among displaced persons in Darfur, Sudan. Clin Infect Dis. 2006;42(12):1679-84.  https://doi.org/10.1086/504322  PMID: 16705571 
  10. Christensen PB, Engle RE, Hjort C, Homburg KM, Vach W, Georgsen J, et al. Time trend of the prevalence of hepatitis E antibodies among farmers and blood donors: a potential zoonosis in Denmark. Clin Infect Dis. 2008;47(8):1026-31.  https://doi.org/10.1086/591970  PMID: 18781880 
  11. Dalton HR, Hazeldine S, Banks M, Ijaz S, Bendall R. Locally acquired hepatitis E in chronic liver disease. Lancet. 2007;369(9569):1260.  https://doi.org/10.1016/S0140-6736(07)60595-9  PMID: 17434400 
  12. Péron JM, Bureau C, Poirson H, Mansuy JM, Alric L, Selves J, et al. Fulminant liver failure from acute autochthonous hepatitis E in France: description of seven patients with acute hepatitis E and encephalopathy. J Viral Hepat. 2007;14(5):298-303.  https://doi.org/10.1111/j.1365-2893.2007.00858.x  PMID: 17439518 
  13. Kamar N, Selves J, Mansuy JM, Ouezzani L, Péron JM, Guitard J, et al. Hepatitis E virus and chronic hepatitis in organ-transplant recipients. N Engl J Med. 2008;358(8):811-7.  https://doi.org/10.1056/NEJMoa0706992  PMID: 18287603 
  14. Legrand-Abravanel F, Kamar N, Sandres-Saune K, Garrouste C, Dubois M, Mansuy JM, et al. Characteristics of autochthonous hepatitis E virus infection in solid-organ transplant recipients in France. J Infect Dis. 2010;202(6):835-44.  https://doi.org/10.1086/655899  PMID: 20695798 
  15. Baylis SA, Gärtner T, Nick S, Ovemyr J, Blümel J. Occurrence of hepatitis E virus RNA in plasma donations from Sweden, Germany and the United States. Vox Sang. 2012;103(1):89-90.  https://doi.org/10.1111/j.1423-0410.2011.01583.x  PMID: 22220775 
  16. 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(3):272.  https://doi.org/10.1111/j.1423-0410.2011.01554.x  PMID: 21957873 
  17. 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(8):2708-13.  https://doi.org/10.1128/JCM.01119-12  PMID: 22675127 
  18. Hewitt PE, Ijaz S, Brailsford SR, Brett R, Dicks S, Haywood B, et al. Hepatitis E virus in blood components: a prevalence and transmission study in southeast England. Lancet. 2014;384(9956):1766-73.  https://doi.org/10.1016/S0140-6736(14)61034-5  PMID: 25078306 
  19. Hogema BM, Molier M, Slot E, Zaaijer HL. Past and present of hepatitis E in the Netherlands. Transfusion. 2014;54(12):3092-6.  https://doi.org/10.1111/trf.12733  PMID: 24889277 
  20. Dalton HR, Bendall R, Ijaz S, Banks M. Hepatitis E: an emerging infection in developed countries. Lancet Infect Dis. 2008;8(11):698-709.  https://doi.org/10.1016/S1473-3099(08)70255-X  PMID: 18992406 
  21. Kamar N, Bendall R, Legrand-Abravanel F, Xia NS, Ijaz S, Izopet J, et al. Hepatitis E. Lancet. 2012;379(9835):2477-88.  https://doi.org/10.1016/S0140-6736(11)61849-7  PMID: 22549046 
  22. Baylis SA, Blümel J, Mizusawa S, Matsubayashi K, Sakata H, Okada Y, et al. World Health Organization International Standard to harmonize assays for detection of hepatitis E virus RNA. Emerg Infect Dis. 2013;19(5):729-35.
  23. Blood Advisory Committee. Topic I: Hepatitis E virus (HEV) and blood transfusion safety. 104th Meeting; 20 Sep 2012 Rockville; 2012. Available from: http://www.fda.gov/downloads/advisorycommittees/committeesmeetingmaterials/bloodvaccinesandotherbiologics/bloodproductsadvisorycommittee/ucm319542.pdf
  24. Wenzel JJ, Preiss J, Schemmerer M, Huber B, Jilg W. Test performance characteristics of Anti-HEV IgG assays strongly influence hepatitis E seroprevalence estimates. J Infect Dis. 2013;207(3):497-500.  https://doi.org/10.1093/infdis/jis688  PMID: 23148290 
  25. Takahashi M, Kusakai S, Mizuo H, Suzuki K, Fujimura K, Masuko K, et al. Simultaneous detection of immunoglobulin A (IgA) and IgM antibodies against hepatitis E virus (HEV) Is highly specific for diagnosis of acute HEV infection. J Clin Microbiol. 2005;43(1):49-56.  https://doi.org/10.1128/JCM.43.1.49-56.2005  PMID: 15634950 
  26. Bendall R, Ellis V, Ijaz S, Thurairajah P, Dalton HR. Serological response to hepatitis E virus genotype 3 infection: IgG quantitation, avidity, and IgM response. J Med Virol. 2008;80(1):95-101.  https://doi.org/10.1002/jmv.21033  PMID: 18041018 
  27. Khuroo MS, Kamili S, Dar MY, Moecklii R, Jameel S. Hepatitis E and long-term antibody status. Lancet. 1993;341(8856):1355.  https://doi.org/10.1016/0140-6736(93)90873-F  PMID: 8098491 
  28. Mansuy JM, Peron JM, Bureau C, Alric L, Vinel JP, Izopet J. Immunologically silent autochthonous acute hepatitis E virus infection in France. J Clin Microbiol. 2004;42(2):912-3.  https://doi.org/10.1128/JCM.42.2.912-913.2004  PMID: 14766888 
  29. Dreier J, Juhl D. Autochthonous hepatitis e virus infections: a new transfusion-associated risk? Transfus Med Hemother. 2014;41(1):29-39.  https://doi.org/10.1159/000357098  PMID: 24659945 
  30. Huzly D, Umhau M, Bettinger D, Cathomen T, Emmerich F, Hasselblatt P, et al. Transfusion-transmitted hepatitis E in Germany, 2013. Euro Surveill. 2014;19(21):20812.  https://doi.org/10.2807/1560-7917.ES2014.19.21.20812  PMID: 24906377 
  31. Baylis SA, Koc O, Nick S, Blümel J. Widespread distribution of hepatitis E virus in plasma fractionation pools. Vox Sang. 2012;102(2):182-3.  https://doi.org/10.1111/j.1423-0410.2011.01527.x  PMID: 21806631 
  32. Beale MA, Tettmar K, Szypulska R, Tedder RS, Ijaz S. Is there evidence of recent hepatitis E virus infection in English and North Welsh blood donors? Vox Sang. 2011;100(3):340-2.  https://doi.org/10.1111/j.1423-0410.2010.01412.x  PMID: 21392024 
  33. Pischke S, Behrendt P, Bock CT, Jilg W, Manns MP, Wedemeyer H. Hepatitis E in Germany--an under-reported infectious disease. Dtsch Arztebl Int. 2014;111(35-36):577-83. PMID: 25249359 
  34. Féray C, Pawlotsky JM, Roque-Afonso AM, Samuel D, Dhumeaux D. Should we screen blood products for hepatitis E virus RNA? Lancet. 2014;383(9913):218.  https://doi.org/10.1016/S0140-6736(14)60072-6  PMID: 24439737 
  35. Juhl D, Baylis SA, Blümel J, Görg S, Hennig H. Seroprevalence and incidence of hepatitis E virus infection in German blood donors. Transfusion. 2014;54(1):49-56.  https://doi.org/10.1111/trf.12121  PMID: 23441647 
Hepatitis E in blood donors: investigation of the natural course of asymptomatic infection, Germany, 2011
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Tanja+Vollmer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vollmer Tanja</a>, <a href="/search?value1=Juergen+Diekmann&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Diekmann Juergen</a>, <a href="/search?value1=Matthias+Eberhardt&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Eberhardt Matthias</a>, <a href="/search?value1=Cornelius+Knabbe&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Knabbe Cornelius</a>, <a href="/search?value1=Jens+Dreier&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Dreier Jens</a></span>. Hepatitis E in blood donors: investigation of the natural course of asymptomatic infection, Germany, 2011. <a href="/content/ecdc">Euro Surveill.</a> 2016;21(35):pii=30332. <a href="https://doi.org/10.2807/1560-7917.ES.2016.21.35.30332" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2016.21.35.30332</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 02 Sept 2015;&nbsp;&nbsp; <span class="generated">Accepted</span>: 16 Feb 2016 </span> </p>
/content/10.2807/1560-7917.ES.2016.21.35.30332
/content/10.2807/1560-7917.ES.2016.21.35.30332
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error