Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Vox Sang. 2020 Apr;115(3):120-132. doi: 10.1111/vox.12887. Epub 2020 Feb 6.
Hepatitis E virus (HEV) is usually transmitted by faecal-oral route. Recent reports have documented HEV viraemia in donated blood units and HEV transmission through blood transfusion. This systematic review summarizes the available data on prevalence of HEV viraemia in blood donors.
Electronic databases were searched on 17 December 2018 to identify full-text English papers reporting original data on prevalence of HEV RNA in donated blood units. Two authors independently extracted the relevant data, which were pooled using simple aggregation as well as a random-effects meta-analysis; heterogeneity was assessed using the I method.
In all, 59 data sets from 28 countries were identified. The available data showed marked heterogeneity. Of a total of 2 127 832 units studied, 561 (263·6 [95% confidence intervals = 242·7-286·4] per million units) tested positive for HEV RNA. On random-effects meta-analysis, the pooled prevalence was 60·9 [6·7-155·4] per million units. In the viraemic units, HEV RNA titre varied by nearly one million-fold, and most had genotype 3 HEV. The prevalence was higher in blood units with anti-HEV antibodies or elevated alanine aminotransferase. Only nearly one-fourth of viraemic units had anti-HEV antibodies.
The prevalence of HEV viraemia among healthy blood donors is low, though the available data had limited geographical representation and marked heterogeneity. There is a need for further data on HEV viraemia in blood donors from areas with non-3 HEV genotype preponderance.
戊型肝炎病毒（HEV）通常通过粪-口途径传播。最近的报告记录了献血单位中的 HEV 血症和通过输血传播的 HEV。本系统评价总结了献血者中 HEV 血症流行率的现有数据。
于 2018 年 12 月 17 日检索电子数据库，以确定报告献血单位中 HEV RNA 流行率原始数据的全文英文论文。两位作者独立提取相关数据，使用简单聚合和随机效应荟萃分析进行汇总；使用 I 方法评估异质性。
共确定了来自 28 个国家的 59 个数据集。可用数据显示出明显的异质性。在总共研究的 2127832 个单位中，有 561 个（每百万单位 263.6[95%置信区间 242.7-286.4]）检测到 HEV RNA 阳性。在随机效应荟萃分析中，汇总的流行率为 60.9[6.7-155.4]每百万单位。在病毒血症单位中，HEV RNA 滴度变化近 100 万倍，大多数为 3 型 HEV。在具有抗-HEV 抗体或丙氨酸氨基转移酶升高的血液单位中，流行率更高。只有近四分之一的病毒血症单位具有抗-HEV 抗体。
健康献血者中 HEV 血症的流行率较低，但现有数据在地域代表性和明显异质性方面有限。需要进一步了解非 3 型 HEV 基因型为主地区的献血者中 HEV 血症的数据。
