Retrospective analysis of blood transfusion recipients: Evidence for post-transfusion hepatitis E

Background and Objectives: Of 200 volunteer blood donors we had screened ea rlier for hepatitis E virus (HEV)RNA, using reverse-transcription polymeras e chain reaction, 3 were positive, raising the possibility of transfusion-a ssociated hepatitis E in areas endemic for this virus. This retrospective s tudy was to reassess the extent of post-transfusion hepatitis E among trans fusion recipients, investigated in 1982, Materials and Methods: We re-evalu ated 56 recipients followed biweekly for 3 months after transfusion. The co ntrols were 51 normal, healthy persons who gave blood at a 2-month interval , as well as 412 blood donors from whom blood was taken once in 1982, Resul ts: Of the 56 transfusion recipients, 19 were positive for IgG antibodies a gainst HEV (anti-HEV) in the pretransfusion sample. Two of the 37 IgG anti- HEV-negative recipients seroconverted to IgM and IgG anti-HEV 5 and 4 weeks after transfusion, 1 with raised serum alanine aminotransferase levels. No ne showed symptoms of hepatitis. Attempts to detect HEV RNA in transfused b lood, from aliquot units stored at -20 degrees C for over 17 years, were no t successful. Of the controls, 17 out of 51 were IgG anti-HEV positive in t he initial sample itself. None of the 34 IgG anti-HEV-negative controls ser oconverted during the 2-month follow-up. Of the blood donors, 154 out of 41 2 were IgG anti-HEV positive. None of the 412 donors had circulating IgM an ti-HEV antibodies. A significantly higher (p<0.03) proportion of susceptibl e transfusion recipients were IgM anti-HEV positive as compared with suscep tible blood donors. Conclusion: The results suggest that, in countries wher e HEV is endemic, the transmission of hepatitis E may be associated with bl ood transfusion. Copyright (C) 2000 S. Karger AG, Basel.