Community Centre for Blood and Tissues of Asturias, Oviedo, Spain.
Regional Transfusion Blood Center, Toledo, Spain.
Transfusion. 2023 Sep;63(9):1767-1772. doi: 10.1111/trf.17498. Epub 2023 Aug 18.
Few cases of transfusion-transmitted hepatitis E virus (HEV) have been published in Spain. Here, we describe a well-characterized lookback investigation of a transfusion-transmitted HEV case at the Community Centre for Blood and Tissues of Asturias (Spain).
A female patient with chronic myeloid leukemia underwent an allogeneic bone marrow transplant in March 2019 and showed alterations in liver function shortly afterwards. This patient received blood components from 30 different donors in the 3 months before the transplant. Frozen plasma samples from these donations were investigated for the presence of HEV-RNA. One frequent donor was identified as asymptomatic HEV RNA-positive at the time of his whole blood donation. The investigation revealed that this donor's plasma unit, originally intended for the fractionation industry, had a viral RNA concentration of 1.9 × 10 copies/mL. HEV RNA was detected initially in the index patient who received the red cell concentrate from this donor 25 days after the transfusion. HEV RNA isolated from both donor and recipient were identified as subtype 3f. The recipient of platelet concentrate (PC), treated with a riboflavin-based pathogen reduction technology (PRT) was not infected, being negative for the presence of HEV IgM, IgG, and HEV RNA before and after the transfusion.
This case study shows that HEV was transmitted through red cell transfusion to a recipient, while the patient who received riboflavin/UV light treated PC did not develop signs of infection. A causal relationship between PRT treatment of the PC and the non-transmission of HEV remains to be established.
在西班牙，鲜有输血传播性戊型肝炎病毒（HEV）的病例报道。在此，我们描述了西班牙阿斯图里亚斯血液与组织中心（Community Centre for Blood and Tissues of Asturias）对一起输血传播性 HEV 病例的特征明确的回溯性调查。
一名女性慢性髓性白血病患者于 2019 年 3 月接受了异基因骨髓移植，此后不久肝功能出现异常。在此前 3 个月的移植前，该患者接受了 30 位不同供者的血液成分。对这些捐赠的冷冻血浆样本进行了 HEV-RNA 检测。发现一名经常献血者在全血捐献时无症状但呈 HEV RNA 阳性。调查显示，该供者的血浆单位最初打算用于血液成分分离行业，其病毒 RNA 浓度为 1.9×10 拷贝/ml。HEV RNA 最初在接受该供者红细胞浓缩物输注 25 天后的指数患者中被检测到。从供者和受者中分离出的 HEV RNA 均鉴定为 3f 型。接受了经核黄素/紫外线病原体减少处理技术（PRT）处理的血小板浓缩物（PC）的受者未被感染，在输血前后，HEV IgM、IgG 和 HEV RNA 均为阴性。
本病例研究表明，HEV 通过红细胞输注传播给了受者，而接受了核黄素/紫外线处理的 PC 的患者并未出现感染迹象。PRT 处理 PC 与 HEV 未传播之间的因果关系仍有待确定。
