Key Laboratory of Public Health Safety (Ministry of Education), Fudan University School of Public Health, Shanghai, 200032, China.
Pudong New Area Blood Center, Shanghai, 200127, China.
Virus Res. 2019 May;265:30-33. doi: 10.1016/j.virusres.2019.03.001. Epub 2019 Mar 2.
Hepatitis E virus (HEV) has been divided into eight genotypes and approximately thirty subtypes. Past studies of blood donors have revealed a substantial prevalence of HEV infection. We examined anti-HEV antibodies and HEV RNA in Chinese voluntary blood donors (VBDs). Blood specimens were collected during 2010-2011, 2014-2015, and 2018, and tested for anti-HEV IgG and IgM antibodies. HEV RNA was tested using real-time PCR and nested reverse transcription PCR (RT-PCR). Phylogenetic analysis determined the genotype using MEGA 7.0. Among 4044 VBDs, 2774 were men (68.6%). In total, 19.8% and 1.1% of the VBDs were reactive to anti-HEV IgG and IgM, respectively. The seroprevalence of anti-HEV IgG was significantly associated with age and time period (P < 0.05), whereas anti-HEV IgM was associated with anti-Treponema pallidum and time period (P < 0.05). A total of five specimens were positive for HEV RNA with normal ALT levels. Subtype 4f (n=1; in the specimens reactive to anti-HEV IgM) and 4d (n=3; 1 in the specimens reactive to anti-HEV IgM and 2 in the anti-HEV negative specimens) were found. The last specimen positive for HEV RNA was not genotyped due to failure in amplifying the partial sequence. In conclusion, our study identified HEV subtype 4f for the first time in China. Additionally, we confirmed the high prevalence of HEV in Chinese VBDs. These findings suggest a substantial risk of transfusion-transmitted HEV. Therefore, screening for HEV among Chinese VBDs might be warranted to prevent further transfusion-mediated spread of HEV.
戊型肝炎病毒（HEV）已分为 8 个基因型和大约 30 个亚型。过去对献血者的研究表明，HEV 感染的发生率相当高。我们研究了中国无偿献血者（VBD）中的抗-HEV 抗体和 HEV RNA。血液样本于 2010-2011 年、2014-2015 年和 2018 年采集，并检测抗-HEV IgG 和 IgM 抗体。使用实时 PCR 和巢式逆转录 PCR（RT-PCR）检测 HEV RNA。通过 MEGA 7.0 进行系统进化分析以确定基因型。在 4044 名 VBD 中，男性 2774 名（68.6%）。VBD 中抗-HEV IgG 和 IgM 反应性分别为 19.8%和 1.1%。抗-HEV IgG 的血清阳性率与年龄和时间呈显著相关（P<0.05），而抗-HEV IgM 与抗梅毒螺旋体和时间相关（P<0.05）。共有 5 份 HEV RNA 阳性且 ALT 水平正常的标本。发现 4f 亚型（1 份，抗-HEV IgM 反应性标本）和 4d 亚型（3 份，抗-HEV IgM 反应性标本 1 份，抗-HEV 阴性标本 2 份）。最后一份 HEV RNA 阳性标本由于部分序列扩增失败未能进行基因分型。总之，我们的研究首次在中国发现了 HEV 4f 亚型。此外，我们证实了中国 VBD 中 HEV 的高流行率。这些发现表明，输血传播的 HEV 风险很大。因此，对中国 VBD 进行 HEV 筛查可能有助于防止进一步的输血传播的 HEV 传播。
