Zhang Longmu, Jiao Shuxian, Yang Zhongsi, Xu Lei, Liu Li, Feng Qiuxia, Zhang Xia, Hou Yun, He Shuyi, Saldanha John, Wang Shuang, Wang Bin
Qingdao University Medical College, Qingdao, ShanDong Province, China.
Qingdao Blood Centre, Qingdao, ShanDong Province, China.
Transfusion. 2017 Feb;57(2):248-257. doi: 10.1111/trf.13937. Epub 2016 Dec 30.
The risk of hepatitis E virus (HEV) infection from blood transfusion has raised increasing concern in many countries. Several transfusion-transmitted cases have been described in the United Kingdom and Japan. The objective was to investigate the prevalence of HEV infection among Chinese blood donors and analyze the potential risk of HEV infection through blood transfusion in China.
Major English and Chinese research databases were used as background research for the study of locations, years, and the number of HEV infections among blood donors in China. The pooled, estimated rate of HEV infection was calculated. Subgroup analyses, for age, sex, and alanine aminotransferase (ALT) levels were performed using software for comprehensive meta-analysis.
The pooled rates of anti-HEV IgM- and anti-HEV IgG-positive donations were 1.09% (95% confidence interval [CI], 0.95%-1.26%) and 30% (95% CI, 25%-34%), respectively. The prevalence of anti-HEV IgM was significantly higher in donors with elevated ALT (4.34%) compared with the rate in donors with normal ALT (1.35%; χ = 39.66, p < 0.01). The anti-HEV IgM and IgG rates were higher in the Southwest region (1.58 and 41%, respectively) compared to the rates in other regions of China (chi-square test, p < 0.05). The anti-HEV IgG rate was also significantly higher in donors 30 years and older compared with donors between 18 and 29 years of age (39% vs. 22%, respectively; χ = 1457.10, p < 0.01). Genetic analysis of HEV from RNA-positive donors indicated that the majority of HEV infections were Genotype 1 (19/33 = 58%), while the remaining 14 isolates were Genotype 4 (14/33 = 42%; χ = 0.758, p > 0.05).
Qualified donations after routine blood donor screening still carry a potential risk for transmitting HEV. The major genotypes in Chinese donors in this study were Genotypes 1 and 4.
在许多国家，输血感染戊型肝炎病毒（HEV）的风险日益受到关注。英国和日本已报道了数例输血传播的病例。目的是调查中国献血者中HEV感染的流行情况，并分析在中国通过输血感染HEV的潜在风险。
使用主要的英文和中文研究数据库作为背景研究，以了解中国献血者中HEV感染的地点、年份和数量。计算合并的HEV感染估计率。使用综合荟萃分析软件对年龄、性别和丙氨酸氨基转移酶（ALT）水平进行亚组分析。
抗HEV IgM和抗HEV IgG阳性献血的合并率分别为1.09%（95%置信区间[CI]，0.95%-1.26%）和30%（95% CI，25%-34%）。ALT升高的献血者中抗HEV IgM的患病率（4.34%）显著高于ALT正常的献血者（1.35%；χ² = 39.66，p < 0.01）。与中国其他地区相比，西南地区的抗HEV IgM和IgG率更高（分别为1.58%和41%；卡方检验，p < 0.05）。30岁及以上献血者的抗HEV IgG率也显著高于18至29岁的献血者（分别为39%和22%；χ² = 1457.10，p < 0.01）。对RNA阳性献血者的HEV进行基因分析表明，大多数HEV感染为1型（19/33 = 58%），其余14株为4型（14/33 = 42%；χ² = 0.758，p > 0.05）。
常规献血者筛查后的合格献血仍存在传播HEV的潜在风险。本研究中中国献血者的主要基因型为1型和4型。
