Unique clinical courses of transfusion‐transmitted hepatitis E in patients with immunosuppression. Issue 2 (31st January 2017)

• Record Type: Journal Article
• Authors: Satake, Masahiro; Matsubayashi, Keiji; Hoshi, Yuji; Taira, Rikizo; Furui, Yasumi; Kokudo, Norihiro; Akamatsu, Nobuhisa; Yoshizumi, Tomoharu; Ohkohchi, Nobuhiro; Okamoto, Hiroaki; Miyoshi, Masato; Tamura, Akinori; Fuse, Kyoko; Tadokoro, Kenji
• Is Part Of: Transfusion. Volume 57:Issue 2(2017)
• Page Start: 280
• Page End: 288
• Publication Date: 2017-01-31
• Subjects: Hematology -- Periodicals; Blood -- Transfusion -- Periodicals; Blood Group Antigens -- Periodicals; Blood Preservation -- Periodicals; Blood Transfusion -- Periodicals; 615
• DOI: 10.1111/trf.13994
• Languages: English
• ISSNs: 0041-1132

Abstract

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 × 10 4 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.