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Transfusion-Transmitted Hepatitis E Virus Infection in France

Authors: Gallian, Pierre; Pouchol, Elodie; Djoudi, Rachid; Lhomme, Sébastien; Mouna, Lina; Gross, Sylvie; Bierling, Philippe; +6 Authors

Transfusion-Transmitted Hepatitis E Virus Infection in France

Abstract

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.

Keywords

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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    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
56
Top 1%
Top 10%
Top 10%
Green
bronze