
pmid: 31327668
There is growing concern regarding the risk of transfusion- transmitted (TT) hepatitis E. Since the first described case in 2006, several TT hepatitis E have been reported to the French hemovigilance network. We performed a retrospective analysis of all cases of TT hepatitis E reported between 2006 and 2016. Transfusion-transmitted hepatitis E with high imputability according to phylogenetic analysis occurred in 23 patients aged 8 to 88 years and involved mostly solid organ recipients (n = 9) or patients with malignant hematological diseases (n = 9, including 4 hematopoietic allograft recipients). Involved blood products were plasma (n = 7), among which 6 had undergone pathogen reduction with solvent/detergent (n = 4) or amotosalen + ultra-violet A (UVA) (n = 2 from 1 donation) treatments, red blood concentrates (n = 7), apheresis platelets concentrates (n = 3) and whole blood pooled platelets concentrates (n = 6), among which one had underwent amotosalen + UVA treatment. Median hepatitis E virus (HEV) RNA dose infused was 5.79 [4.36-10.10] log IU. HEV infection progressed to chronic hepatitis E in 14 (61%) immunocompromised patients, 2 of whom had advanced liver fibrosis at diagnosis. Chronic hepatitis E patients cleared HEV with ribavirin treatment (n = 10), after immunosuppressive drug reduction (n = 3), or spontaneously (n = 1). One additional organ transplant recipient with associated co-morbidities died with ongoing HEV infection and multiple organ failure. The other 8 (34.8%) patients with TT hepatitis E cleared HEV within 6 months with ribavirin treatment (n = 3), reduced immunosuppression (n = 1) or spontaneously (n = 4). Red cells, platelets, and plasma transfusions may be associated with TT hepatitis E that can evolve to chronic hepatitis E in immunocompromised patients. Hepatitis E virus has emerged in France as a clinically significant TT infection risk.
Male, [SDV]Life Sciences [q-bio], MESH: Blood Donors / statistics & numerical data, Blood Donors, Severity of Illness Index, MESH: Risk Factors, Risk Factors, MESH: Child, 80 and over, Child, MESH: Blood Safety / statistics & numerical data, MESH: Aged, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Aged, 80 and over, MESH: France / epidemiology, MESH: Middle Aged, Middle Aged, Hepatitis E, [SDV] Life Sciences [q-bio], MESH: Transfusion Reaction / diagnosis, MESH: Young Adult, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Acute Disease, MESH: Acute Disease, Female, France, Transfusion-transmitted infection, Adult, Adolescent, Blood Safety, 610, MESH: Hepatitis E / diagnosis, Young Adult, MESH: Severity of Illness Index, 616, Hepatitis E virus, Humans, Aged, Retrospective Studies, MESH: Adolescent, MESH: Hepatitis E / epidemiology, MESH: Humans, MESH: Chronic Disease, MESH: Hepatitis E / transmission, MESH: Transfusion Reaction / epidemiology, Transfusion Reaction, MESH: Adult, MESH: Retrospective Studies, MESH: Male, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Chronic Disease, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Female
Male, [SDV]Life Sciences [q-bio], MESH: Blood Donors / statistics & numerical data, Blood Donors, Severity of Illness Index, MESH: Risk Factors, Risk Factors, MESH: Child, 80 and over, Child, MESH: Blood Safety / statistics & numerical data, MESH: Aged, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Aged, 80 and over, MESH: France / epidemiology, MESH: Middle Aged, Middle Aged, Hepatitis E, [SDV] Life Sciences [q-bio], MESH: Transfusion Reaction / diagnosis, MESH: Young Adult, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Acute Disease, MESH: Acute Disease, Female, France, Transfusion-transmitted infection, Adult, Adolescent, Blood Safety, 610, MESH: Hepatitis E / diagnosis, Young Adult, MESH: Severity of Illness Index, 616, Hepatitis E virus, Humans, Aged, Retrospective Studies, MESH: Adolescent, MESH: Hepatitis E / epidemiology, MESH: Humans, MESH: Chronic Disease, MESH: Hepatitis E / transmission, MESH: Transfusion Reaction / epidemiology, Transfusion Reaction, MESH: Adult, MESH: Retrospective Studies, MESH: Male, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Chronic Disease, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Female
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