Mar Riveiro-Barciela1,2, Silvia Sauleda2,3, Josep Quer2,4, Fernando Salvador5, Josep Gregori2,4, María Pirón3, Francisco Rodríguez-Frías2,6, Maria Buti1,2. 1. Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d'Hebron and Universitat Autònoma de Barcelona, Barcelona, Spain. 2. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain. 3. Transfusion Safety Laboratory, Banc de Sang i Teixits, Servei Català de la Salut. 4. Liver Unit, Internal Medicine, Lab. Malalties Hepàtiques, Vall d'Hebron Institut Recerca-Hospital Universitari Vall d'Hebron (VHIR-HUVH). 5. Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, PROSICS Barcelona. 6. Liver Pathology Unit, Departments of Biochemistry and Microbiology (Virology Unit), Hospital Universitari Vall d'Hebron and Universitat Autònoma de Barcelona, Barcelona, Spain.
Abstract
BACKGROUND: Acute hepatitis E in industrialized countries is usually related to intake or manipulation of undercooked or raw meat. Cases of transfusion-transmitted hepatitis E have rarely been documented in immunosuppressed patients, mainly after receiving frozen plasma. STUDY DESIGN AND METHODS: A 61-year-old man was admitted to hospital for jaundice. His personal history included disseminated bacillus Calmette-Guerin infection treated with antituberculous drugs. He had received red blood cell (RBC) transfusion 2 months previously, during admission for mycotic aneurysm surgery. Since liver function tests worsened despite stopping antituberculous drugs, other causes of acute hepatitis were explored. RESULTS: Acute hepatitis E was diagnosed by the presence of both immunoglobulin M and hepatitis E virus (HEV) RNA. Traceback procedure for the 8 RBC units was carried out, and one of the eight archive plasma samples tested positive for HEV RNA, with an estimated viral load of 75,000 IU/mL. Phylogenetic analysis revealed the same HEV strain Genotype 3 in one of the transfused RBC products and in the patient's serum sample. CONCLUSION: Transfusion of RBCs with detectable HEV RNA is a risk factor for acute hepatitis E in immunocompetent patients in Europe.
BACKGROUND: Acute hepatitis E in industrialized countries is usually related to intake or manipulation of undercooked or raw meat. Cases of transfusion-transmitted hepatitis E have rarely been documented in immunosuppressed patients, mainly after receiving frozen plasma. STUDY DESIGN AND METHODS: A 61-year-old man was admitted to hospital for jaundice. His personal history included disseminated bacillus Calmette-Guerininfection treated with antituberculous drugs. He had received red blood cell (RBC) transfusion 2 months previously, during admission for mycotic aneurysm surgery. Since liver function tests worsened despite stopping antituberculous drugs, other causes of acute hepatitis were explored. RESULTS: Acute hepatitis E was diagnosed by the presence of both immunoglobulin M and hepatitis E virus (HEV) RNA. Traceback procedure for the 8 RBC units was carried out, and one of the eight archive plasma samples tested positive for HEV RNA, with an estimated viral load of 75,000 IU/mL. Phylogenetic analysis revealed the same HEV strain Genotype 3 in one of the transfused RBC products and in the patient's serum sample. CONCLUSION: Transfusion of RBCs with detectable HEV RNA is a risk factor for acute hepatitis E in immunocompetent patients in Europe.
Authors: Dragoslav Domanović; Richard Tedder; Johannes Blümel; Hans Zaaijer; Pierre Gallian; Christoph Niederhauser; Silvia Sauleda Oliveras; Joan O'Riordan; Fiona Boland; Lene Harritshøj; Maria São José Nascimento; Anna Rita Ciccaglione; Constatina Politis; Cornelia Adlhoch; Benoit Flan; Wahiba Oualikene-Gonin; Guy Rautmann; Paul Strengers; Patricia Hewitt Journal: Euro Surveill Date: 2017-04-20
Authors: Thomas Horvatits; Julian Schulze Zur Wiesch; Marc Lütgehetmann; Ansgar W Lohse; Sven Pischke Journal: Viruses Date: 2019-07-05 Impact factor: 5.048