Division of Clinical Diagnostics and Surgery, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
Octapharma AB, Stockholm, Sweden.
J Viral Hepat. 2022 Sep;29(9):835-839. doi: 10.1111/jvh.13682. Epub 2022 May 13.
Hepatitis E virus (HEV) is endemic in Europe. However, standardized methods for the surveillance of HEV viremia in the general population are lacking. This study aimed to compare the incidence of HEV among blood donors in two European countries, Germany and Portugal, during the period 2015-2018. The seasonal distribution of HEV infection, as well as host risk factors including age, sex, and blood group phenotype were explored. A total of 191,236 donations from Germany and Portugal were tested for HEV RNA in plasma mini-pools of up to 96 donations using an internally controlled reverse transcription real-time PCR (RT-PCR) assay. The 95% cut-off of the assay was 15 International Units (IU)/mL (CI 10-35 IU/mL) as determined by dilution of the WHO International Standard for HEV RNA. Blood type was determined by agglutination and pattern recognition using the Beckmann Coulter PK 7300 AB0- and Rhesus-Assay. The overall positivity rate was 0.09% with significantly more infections observed in the German cohort (p < 0.0001). Infections peaked in the summer months, and investigation of risk factors revealed that incidence was significantly higher amongst males (p = 0.0002), but was not associated with ABO or Rh(D) blood group phenotypes. No significant relationships between risk factors and viral load were observed. Our findings confirm that HEV infections are highly prevalent in Europe, even amongst otherwise healthy blood donors. Increasing awareness of the seasonal spread and risk factors for HEV transmission is of great importance for individuals susceptible to more severe forms of the disease, such as immunocompromised patients.
戊型肝炎病毒（HEV）在欧洲流行。然而，目前缺乏针对普通人群中 HEV 血症的监测的标准化方法。本研究旨在比较 2015-2018 年间德国和葡萄牙两个欧洲国家献血者中 HEV 的发病率。本研究还探讨了 HEV 感染的季节性分布，以及包括年龄、性别和血型表型在内的宿主危险因素。使用内部控制的逆转录实时 PCR（RT-PCR）检测方法，对来自德国和葡萄牙的 191236 份献血样本进行了血浆微池检测，每个微池样本最多可检测 96 份样本。该检测方法的 95%截断值为 15 国际单位（IU）/毫升（CI 10-35 IU/ml），该值通过对世界卫生组织 HEV RNA 国际标准进行稀释确定。血型通过凝集和使用 Beckmann Coulter PK 7300 AB0-和 Rh 系统测定法进行的模式识别来确定。总阳性率为 0.09%，德国队列的感染率明显更高（p < 0.0001）。感染高峰期在夏季，对危险因素的调查显示，男性发病率明显更高（p = 0.0002），但与 ABO 或 Rh（D）血型表型无关。未观察到危险因素与病毒载量之间存在显著关系。我们的研究结果证实，HEV 感染在欧洲非常普遍，即使在其他方面健康的献血者中也是如此。提高对 HEV 传播的季节性传播和危险因素的认识，对于易患更严重疾病形式（如免疫功能低下的患者）的个体非常重要。
