State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, Xiamen, Fujian, 361102, PR China.
Xiamen Blood Service, Xiamen, Fujian, 361005, PR China.
Emerg Microbes Infect. 2018 Jul 5;7(1):125. doi: 10.1038/s41426-018-0125-y.
Hepatitis E virus (HEV) is emerging as a potential threat to the safety of blood transfusions. In many countries and regions endemic for HEV, such as China, blood donors are not routinely tested for HEV infection. In this study, 11747 eligible blood donors were screened for anti-HEV immunoglobulin M (IgM)/immunoglobulin G (IgG) and HEV RNA and antigen in China. Twenty-four donors who were positive for both HEV antigen and RNA were followed for ≥ 70 days, and none of these donors reported clinical hepatitis or illness. At least 1 follow-up sample was provided by 17 donors, including 10 with viremia and/or antigenemia for ≥ 70 days and 3 with antigen and RNA positivity for >90 days. Fourteen of the 17 donors did not present with an obvious serologic response during the follow-up period. These results differed from previous reports, in which viremia lasted for 68 days and elicited an antibody response. These donors showed atypical HEV infection progression that differed from that of hepatitis E patients. The presence of these donors presents a challenge for transfusion transmission screening.
戊型肝炎病毒（HEV）正成为输血安全的潜在威胁。在许多存在 HEV 的国家和地区，如中国，献血者通常不会常规检测 HEV 感染。本研究在中国筛查了 11747 名合格献血者的抗-HEV 免疫球蛋白 M（IgM）/免疫球蛋白 G（IgG）和 HEV RNA 和抗原。24 名同时对 HEV 抗原和 RNA 呈阳性的献血者接受了≥70 天的随访，这些献血者均未报告临床肝炎或疾病。至少有 17 名献血者提供了 1 份以上的随访样本，其中 10 名献血者的病毒血症和/或抗原血症持续≥70 天，3 名献血者的抗原和 RNA 阳性持续时间超过 90 天。17 名献血者中的 14 名在随访期间未出现明显的血清学反应。这些结果与之前的报告不同，之前的报告显示病毒血症持续 68 天并引发抗体反应。这些献血者表现出与戊型肝炎患者不同的非典型 HEV 感染进展。这些献血者的存在给输血传播筛查带来了挑战。
