Red blood cell transfusion‐transmitted acute hepatitis E in an immunocompetent subject in Europe: a case report. Issue 2 (26th October 2016)

• Record Type: Journal Article
• Authors: Riveiro‐Barciela, Mar; Sauleda, Silvia; Quer, Josep; Salvador, Fernando; Gregori, Josep; Pirón, María; Rodríguez‐Frías, Francisco; Buti, Maria
• Is Part Of: Transfusion. Volume 57:Issue 2(2017)
• Page Start: 244
• Page End: 247
• Publication Date: 2016-10-26
• Subjects: Hematology -- Periodicals; Blood -- Transfusion -- Periodicals; Blood Group Antigens -- Periodicals; Blood Preservation -- Periodicals; Blood Transfusion -- Periodicals; 615
• DOI: 10.1111/trf.13876
• Languages: English
• ISSNs: 0041-1132

Abstract

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.