Masahiro Satake1, Keiji Matsubayashi1, Yuji Hoshi1, Rikizo Taira2, Yasumi Furui2, Norihiro Kokudo3, Nobuhisa Akamatsu3, Tomoharu Yoshizumi4, Nobuhiro Ohkohchi5, Hiroaki Okamoto6, Masato Miyoshi7, Akinori Tamura8,9, Kyoko Fuse10, Kenji Tadokoro2. 1. Japanese Red Cross Central Blood Institute. 2. Japanese Red Cross Blood Service Headquarters. 3. Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. 4. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 5. Division of Gastroenterological and Hepatobiliary Surgery and Organ Transplantation, Department of Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan. 6. Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Tochigi, Japan. 7. Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University. 8. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nihon University School of Medicine. 9. Tamura Medical Clinic, Tokyo, Japan. 10. Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine, Niigata, Japan.
Abstract
BACKGROUND: The high prevalence of specific immunoglobulin G for hepatitis E virus (HEV) in Japanese people raises the possibility of a high incidence of HEV-viremic blood donors and therefore frequent transfusion-transmitted HEV (TT-HEV). STUDY DESIGN AND METHODS: TT-HEV cases established in Japan through hemovigilance and those published in the literature were collected. Infectivity of HEV-contaminated blood components and disease severity in relation to immunosuppression were investigated. RESULTS: Twenty established TT-HEV cases were recorded over the past 17 years. A lookback study verified that five of 10 patients transfused with known HEV-contaminated blood components acquired HEV infection. The minimal infectious dose of HEV through transfusion was 3.6 × 104 IU. Nine of the 19 TT-HEV cases analyzed had hematologic diseases. Only two cases showed the maximal alanine aminotransferase level of more than 1000 U/L. Two patients with hematologic malignancy and two liver transplant recipients had chronic liver injury of moderate severity. CONCLUSION: The infectivity of HEV-contaminated components was 50%. Immunosuppression likely causes the moderate illness of TT-HEV, but it may lead to the establishment of chronic sequelae. Transfusion recipients, a population that is variably immunosuppressed, are more vulnerable to chronic liver injury as a result of TT-HEV than the general population is as a result of food-borne infection.
BACKGROUND: The high prevalence of specific immunoglobulin G for hepatitis E virus (HEV) in Japanese people raises the possibility of a high incidence of HEV-viremic blood donors and therefore frequent transfusion-transmitted HEV (TT-HEV). STUDY DESIGN AND METHODS: TT-HEV cases established in Japan through hemovigilance and those published in the literature were collected. Infectivity of HEV-contaminated blood components and disease severity in relation to immunosuppression were investigated. RESULTS: Twenty established TT-HEV cases were recorded over the past 17 years. A lookback study verified that five of 10 patients transfused with known HEV-contaminated blood components acquired HEVinfection. The minimal infectious dose of HEV through transfusion was 3.6 × 104 IU. Nine of the 19 TT-HEV cases analyzed had hematologic diseases. Only two cases showed the maximal alanine aminotransferase level of more than 1000 U/L. Two patients with hematologic malignancy and two liver transplant recipients had chronic liver injury of moderate severity. CONCLUSION: The infectivity of HEV-contaminated components was 50%. Immunosuppression likely causes the moderate illness of TT-HEV, but it may lead to the establishment of chronic sequelae. Transfusion recipients, a population that is variably immunosuppressed, are more vulnerable to chronic liver injury as a result of TT-HEV than the general population is as a result of food-borne infection.
Authors: John R Ticehurst; Nora Pisanic; Michael S Forman; Carly Ordak; Christopher D Heaney; Edgar Ong; Jeffrey M Linnen; Paul M Ness; Nan Guo; Hua Shan; Kenrad E Nelson Journal: Transfusion Date: 2019-01-31 Impact factor: 3.157
Authors: Lisa Dähnert; Martin Eiden; Josephine Schlosser; Christine Fast; Charlotte Schröder; Elke Lange; Albrecht Gröner; Wolfram Schäfer; Martin H Groschup Journal: BMC Vet Res Date: 2018-12-04 Impact factor: 2.741
Authors: Juliana Gil Melgaço; Noemi Rovaris Gardinali; Vinicius da Motta de Mello; Mariana Leal; Lia Laura Lewis-Ximenez; Marcelo Alves Pinto Journal: Biomed Res Int Date: 2018-01-09 Impact factor: 3.411