Transmission of hepatitis E virus (HEV) through blood products is still a matter of debate. Asymptomatic viremia has been reported in blood donors from several European countries and HEV transmission in recipients of blood components has been documented in Europe and Japan. In plasma-derived products, HEV transmission has not been observed so far although HEV RNA was detected in plasma fractionation pools.

In this retrospective study, 36 patients with thrombotic thrombocytopenic purpura requiring plasma exchange were analysed for the possibility of HEV transmission. Patients received either solvent-detergent (SD) virus inactivated plasma or cryosupernatant plasma. Samples were drawn from TTP patients at time 0, 1 and 6 month post-treatment and tested for anti-HEV antibodies. If antibodies were detected, patients were tested for viremia by PCR. In 2 of 17 patients treated with SD plasma, HEV antibodies were detectable. HEV RNA was also detected in the 1-month samples from these TTP patients.

In conclusion, the data reported in this study provide evidence of HEV transmission by SD plasma.

– Rainer Moog

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