The clinical significance of hepatitis E virus (HEV) in blood transfusion is a matter of debate. Transfusion transmissions of HEV have been documented worldwide. HEV is a common cause of acute hepatitis. HEV is a single-stranded RNA virus, which is resistant to virus inactivation. Thus, HEV screening is also of interest for some plasma manufacturers to remove HEV-positive donors and reduce HEV RNA concentration of plasma pools.
This study by Stramer et al. evaluated the frequency of HEV RNA from 18,829 blood donations from six US regions and IgG and IgM prevalence from a subset of 4,499 donors. Overall antibody prevalence was 7.7%; 0.58% of donors were IgM positive. Two donors from the Midwest region were confirmed positive for HEV RNA (frequency 1 in 9,500). As with other studies, the findings of the present study showed clear age dependence, with greatly increased prevalence among older donors.
The question whether HEV blood donation screening is warranted remained unanswered. There is still an ongoing discussion about providing HEV-negative blood for patients at risk of developing hepatitis.
– Rainer Moog