Costafreda Maria Isabel, Sauleda Silvia, Rico Angie, Piron Maria, Bes Marta
Catalan Blood Bank (Banc de Sang i Teixits de Catalunya), Transfusion Safety Laboratory, Barcelona, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain.
J Infect Dis. 2022 Nov 11;226(10):1753-1760. doi: 10.1093/infdis/jiab589.
Transfusion-transmitted hepatitis E virus (HEV) infections have raised many concerns regarding the safety of blood products. To date, enveloped HEV particles have been described in circulating blood, whereas nonenveloped HEV virions have only been found in feces; however, no exhaustive studies have been performed to fully characterize HEV particles in blood.
Using isopycnic ultracentrifugation, we determined the types of HEV particles in plasma of HEV-infected blood donors.
Nonenveloped HEV was detected in 8 of 23 plasma samples, whereas enveloped HEV was found in all of them. No association was observed between the presence of nonenveloped HEV and viral load, gender, or age at infection. However, samples with HEV-positive serology and/or increased levels of liver injury markers contained a higher proportion of nonenveloped HEV than samples with HEV-negative serology and normal levels of liver enzymes. These results were further confirmed by analyzing paired donation and follow-up samples of 10 HEV-infected donors who were HEV seronegative at donation but had anti-HEV antibodies and/or increased levels of liver enzymes at follow up.
The HEV-contaminated blood products may contain nonenveloped HEV, which may pose an additional risk to blood safety by behaving differently to pathogen inactivation treatments or increasing infectivity.
输血传播的戊型肝炎病毒（HEV）感染引发了人们对血液制品安全性的诸多担忧。迄今为止，在循环血液中已发现有包膜的HEV颗粒，而无包膜的HEV病毒粒子仅在粪便中被发现；然而，尚未进行详尽研究以全面表征血液中的HEV颗粒。
我们使用等密度超速离心法确定了HEV感染献血者血浆中HEV颗粒的类型。
在23份血浆样本中的8份中检测到无包膜的HEV，而所有样本中均发现了有包膜的HEV。未观察到无包膜HEV的存在与病毒载量、性别或感染时年龄之间存在关联。然而，与HEV血清学阴性且肝酶水平正常的样本相比，HEV血清学阳性和/或肝损伤标志物水平升高的样本中无包膜HEV的比例更高。通过分析10名HEV感染献血者的配对献血和随访样本进一步证实了这些结果，这些献血者在献血时HEV血清学阴性，但在随访时具有抗HEV抗体和/或肝酶水平升高。
受HEV污染的血液制品可能含有无包膜的HEV，这可能因对病原体灭活处理反应不同或增加传染性而给血液安全带来额外风险。
