Division of Medical Virology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, South Africa.
Western Cape Blood Service, Cape Town, South Africa.
Vox Sang. 2020 Nov;115(8):695-702. doi: 10.1111/vox.12966. Epub 2020 Jun 29.
Transfusion-transmitted hepatitis E virus (HEV) infection is a potential risk to recipients of blood transfusions. Infection with HEV poses a high risk to immunocompromised recipients with an increased likelihood of developing chronic infection. The aims of this study were to determine the prevalence of past and active HEV infections in donors from the Western Cape and to identify the risk factors associated with infection.
We prospectively tested 10 250 blood donors for HEV infection. A risk factor sub-study investigated 250 donors who completed a questionnaire, and plasma samples were tested for HEV IgG antibodies and pooled for HEV RNA detection. The demographic and risk factors associated with HEV infection were assessed. The molecular study tested 10 000 individual donations using a commercial assay to detect viraemia. HEV viral load and genotype were also determined.
The overall anti-HEV IgG seroprevalence was 42·8% (107/250) among donors participating in the risk factor sub-study. The likelihood of past HEV infection was higher with an increase in age. Of the 10 000 donor samples individually tested for HEV RNA, one sample was positive with a viral load of 7·9 x 10 IU/ml and belonged to HEV genotype 3.
We found a high seroprevalence of anti-HEV IgG but a low HEV RNA prevalence among donors in the Western Cape, South Africa. The study provides evidence for a potential risk of HEV contamination in the blood supply in South Africa. A cost-benefit analysis is needed before considering the introduction of routine donor screening in our setting.
输血传播的戊型肝炎病毒 (HEV) 感染是接受输血者的潜在风险。HEV 感染对免疫功能低下的受者构成高风险，更有可能发展为慢性感染。本研究的目的是确定西开普省献血者既往和现症 HEV 感染的流行率，并确定与感染相关的危险因素。
我们前瞻性检测了 10250 名献血者的 HEV 感染情况。一项危险因素子研究调查了 250 名填写问卷的献血者，并检测了血浆样本中的 HEV IgG 抗体，并对 HEV RNA 进行了检测。评估了与 HEV 感染相关的人口统计学和危险因素。分子研究使用商业检测方法对 10000 份单独的献血样本进行了检测，以检测病毒血症。还确定了 HEV 病毒载量和基因型。
参加危险因素子研究的 250 名献血者中，抗-HEV IgG 总血清阳性率为 42.8%（107/250）。过去 HEV 感染的可能性随着年龄的增长而增加。在对 10000 份单独的 HEV RNA 进行检测的献血者样本中，有 1 份样本呈阳性，病毒载量为 7.9×10 IU/ml，属于 HEV 基因型 3。
我们在南非西开普省的献血者中发现了高抗-HEV IgG 血清阳性率，但 HEV RNA 阳性率较低。该研究为南非血液供应中存在潜在的 HEV 污染风险提供了证据。在我们的环境中考虑常规献血者筛查之前，需要进行成本效益分析。
