Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada; Division of Hematology, Department of Medicine, McGill University, Montreal, Quebec, Canada.
Department of Microbiology, Infectious diseases, and Immunology, Université de Montréal, Montreal, Quebec, Canada; Medical Affairs and Innovation, Héma-Québec, Montreal, Quebec, Canada.
Transfus Med Rev. 2024 Jul;38(3):150835. doi: 10.1016/j.tmrv.2024.150835.
Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis in the world and can lead to severe complications in immunocompromised individuals. HEV is primarily transmitted through eating pork, which has led to an increased in anti-HEV IgG seropositivity in the general population of Europe in particular. However, it can also be transmitted intravenously, such as through transfusions. The growing evidence of HEV contamination of blood products and documented cases of transmission have given rise to practice changes and blood product screening of HEV in many European countries. This review covers the abundant European literature and focuses on the most recent data pertaining to the prevalence of HEV RNA positivity and IgG seropositivity in the North American general population and in blood products from Canada and the United States. Currently, Health Canada and the Food and Drug Administration do not require testing of HEV in blood products. For this reason, awareness among blood product prescribers about the possibility of HEV transmission through blood products is crucial. However, we also demonstrate that the province of Quebec has a prevalence of anti-HEV and HEV RNA positivity similar to some European countries. In light of this, we believe that HEV RNA blood donation screening be reevaluated with the availability of more cost-effective assays.
戊型肝炎病毒 (HEV) 是世界上最常见的急性病毒性肝炎病原体，可导致免疫功能低下个体出现严重并发症。HEV 主要通过食用猪肉传播，这导致欧洲普通人群的抗-HEV IgG 血清阳性率上升。然而，它也可以通过静脉途径传播，例如通过输血。越来越多的血液制品受到 HEV 污染的证据以及已记录的传播病例，促使许多欧洲国家改变了实践，并对 HEV 进行了血液制品筛查。本综述涵盖了丰富的欧洲文献，并重点介绍了有关北美人一般人群中 HEV RNA 阳性率和 IgG 血清阳性率的最新数据，以及来自加拿大和美国的血液制品。目前，加拿大卫生部和美国食品和药物管理局不要求对血液制品进行 HEV 检测。因此，血液制品开单医生对血液制品中 HEV 传播的可能性的认识至关重要。然而，我们也证明，魁北克省的抗-HEV 和 HEV RNA 阳性率与一些欧洲国家相似。有鉴于此，我们认为应重新评估使用更具成本效益的检测方法进行血液捐赠筛查 HEV RNA。
