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Prevalence and risk factors for hepatitis E virus infection in blood donors: a nationwide survey in Italy, 2017 to 2019
- Enea Spada1 , Matteo Simeoni2 , Antonio Martina2 , Ilaria Pati3 , Umbertina Villano1 , Daniela Adriani2 , Agnese D’Angiò2 , Elena Tritarelli1 , Stefania Taffon1 , Stefania Bellino1 , Stefano Boros1 , Roberta Urciuoli1 , Francesca Masiello3 , Giuseppe Marano3 , Roberto Bruni1 , Patrizio Pezzotti1 , Anna Rita Ciccaglione1 , Simonetta Pupella3 , Vincenzo De Angelis3 , Giulio Pisani2
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View Affiliations Hide AffiliationsAffiliations: 1 Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy 2 National Centre for the Control and Evaluation of Medicines, Istituto Superiore di Sanità, Rome, Italy 3 Italian National Blood Centre, Istituto Superiore di Sanità, Rome, ItalyEnea Spadaenea.spada iss.it
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Citation style for this article: Spada Enea, Simeoni Matteo, Martina Antonio, Pati Ilaria, Villano Umbertina, Adriani Daniela, D’Angiò Agnese, Tritarelli Elena, Taffon Stefania, Bellino Stefania, Boros Stefano, Urciuoli Roberta, Masiello Francesca, Marano Giuseppe, Bruni Roberto, Pezzotti Patrizio, Ciccaglione Anna Rita, Pupella Simonetta, De Angelis Vincenzo, Pisani Giulio. Prevalence and risk factors for hepatitis E virus infection in blood donors: a nationwide survey in Italy, 2017 to 2019. Euro Surveill. 2022;27(22):pii=2100516. https://doi.org/10.2807/1560-7917.ES.2022.27.22.2100516 Received: 18 May 2021; Accepted: 21 Jan 2022
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Abstract
In high-income countries, hepatitis E virus (HEV) infection is mainly a zoonosis. However, it is also transfusion-transmissible and some countries, but not Italy, have introduced HEV screening for blood donations.
We assessed HEV infection prevalence and risk factors in a nationwide sample of Italian blood donors.
We selected 107 blood establishments (BE) distributed in the 20 Italian regions by a stratified two-stage design and invited them to participate in the study. Donors were tested for anti-HEV IgG and IgM and HEV RNA. Sociodemographic data and risk factors were collected through a questionnaire.
Overall, 60 BE from 60 provinces in 19 Italian regions joined the study. We assessed HEV markers in 7,172 blood donors, of whom 6,235 completed the questionnaire. Overall crude and adjusted anti-HEV IgG prevalences were 8.3% and 5.5%, respectively. Overall anti-HEV IgM prevalence was 0.5%, while no blood donor was HEV RNA-positive. Anti-HEV IgG prevalence varied widely among regions (range: 1.3%–27.20%) and hyperendemic prevalences (> 40%) were detected in some provinces in two regions. Older age (AOR = 1.81; 95% CI: 1.36–2.41), foreign nationality (AOR = 2.77; 95% CI: 1.06–7.24), eating raw pork liver sausages (AOR = 2.23; 95% CI: 1.55–3.20) and raw homemade sausages (AOR = 3.63; 95% CI: 2.50–5.24) were independent infection predictors.
Italian blood donors showed a low to moderate HEV seroprevalence. High levels in some regions and/or provinces were mainly attributable to eating habits. Prevention should include avoiding consumption of raw or undercooked meat and safe production of commercial pork products.
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