Gallian P, Piquet Y, Assal A, Djoudi R, Chiaroni J, Izopet J, Tiberghien P
Établissement français du sang Alpes Méditerranée, 149, boulevard Baille, 13392 Marseille cedex 5, France; UMR D 190 « Émergence des pathologies virales » (Aix-Marseille University IRD French institute of research for development EHESP French school of public health), Marseille, France.
Établissement français du sang Aquitaine-Limousin, Bordeaux 33035, France.
Transfus Clin Biol. 2014 Nov;21(4-5):173-7. doi: 10.1016/j.tracli.2014.07.007. Epub 2014 Sep 27.
Hepatitis E virus (HEV) is a non-enveloped RNA virus transmitted by the fecal-oral route. Autochthonous hepatitis E occurring in developed countries is caused by genotypes 3 and 4 and is a zoonotic infection. Humans are infected mostly after ingestion of undercooked meat from infected animals. Most HEV 3 and 4 infections are clinically inapparent. However, genotype 3 (HEV 3) can lead to chronic hepatitis in immuno-compromised patients such as organ-transplant recipients and patients with haematological malignancies. In Europe, HEV 3 is implicated in transfusion-transmitted HEV infection. In France, as observed in several European countries, prevalence of HEV RNA and specific IgG antibodies are high indicating that viral circulation is important. The systematic HEV NAT screening of blood donations used for preparation of solvent detergent plasma indicate that 1 to 2218 donation is infected by HEV RNA. The need or implementation's impacts of safety measures to prevent HEV transmission by blood transfusion are under reflexion by French's health authorities. The HEV NAT screening is the only available tool of prevention. Alternative strategies are under investigation including individual or mini pool NAT testing all or part of blood donations.
戊型肝炎病毒（HEV）是一种通过粪-口途径传播的无包膜RNA病毒。在发达国家发生的散发性戊型肝炎由3型和4型基因型引起，是一种人畜共患感染。人类大多在摄入受感染动物的未煮熟肉类后被感染。大多数HEV 3和4型感染在临床上并无明显症状。然而，3型基因型（HEV 3）可导致免疫功能低下患者，如器官移植受者和血液系统恶性肿瘤患者发生慢性肝炎。在欧洲，HEV 3与输血传播的戊型肝炎感染有关。在法国，正如在几个欧洲国家所观察到的那样，HEV RNA和特异性IgG抗体的流行率很高，表明病毒传播情况很严重。对用于制备溶剂去污剂血浆的献血进行系统性HEV核酸检测表明，每2218份献血中有1份被HEV RNA感染。法国卫生当局正在思考预防输血传播HEV的安全措施的必要性及其实施的影响。HEV核酸检测是唯一可用的预防工具。正在研究替代策略，包括对全部或部分献血进行个体或小混合样本核酸检测。
