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OBJECTIVES: The prevalence of active, chronic, and former hepatitis E virus (HEV) infections was investigated in a cohort of immunocompromised patients. The association with transfusion transmitted HEV was evaluated, and the HEV seroprevalence was compared with that in healthy blood donors. STUDY DESIGN AND METHODS: Serum samples from 4023 immunocompromised patients at Rigshospitalet, Denmark were retrospectively tested for HEV RNA and anti-HEV IgG. HEV RNA-positive patients were followed up by HEV testing, clinical symptoms, and transfusion history. Factors associated with anti-HEV were explored by multivariable logistic regression analysis. Samples from 1226 blood donors were retrospectively tested for anti-HEV IgG. RESULTS: HEV RNA was detected in six patients (0.15%) with no indications of chronic HEV infection. HEV RNA prevalence rates among recipients of allogeneic haematopoietic stem cell transplantation (allo-HSCT) and solid organ transplantation (SOT) were 0.58% and 0.21%, respectively. Transfusion transmitted infections were refuted, and transfusion history was not associated with anti-HEV positivity. The difference in HEV seroprevalence between patients (22.0%) and blood donors (10.9%) decreased when adjusting for age and sex (odds ratio 1.20, 95% confidence interval 0.97-1.48). CONCLUSIONS: HEV viremia among allo-HSCT and SOT recipients suggests that clinicians should be aware of this diagnosis. The lack of association of blood transfusion with anti-HEV positivity supports food-borne transmission as the main transmission route of HEV common to both patients and blood donors.

Original publication

DOI

10.1016/j.ijid.2019.11.014

Type

Journal article

Journal

Int J Infect Dis

Publication Date

02/2020

Volume

91

Pages

188 - 195

Keywords

Anti-HEV IgG, Chronic HEV infection, Epidemiology, HEV RNA, Hepatitis E, Immunocompromised, Transfusion transmission, Adolescent, Adult, Aged, Aged, 80 and over, Blood Donors, Cross-Sectional Studies, Denmark, Female, Hepatitis Antibodies, Hepatitis E, Hepatitis E virus, Humans, Immunocompromised Host, Male, Middle Aged, Prevalence, RNA, Viral, Retrospective Studies, Seroepidemiologic Studies, Viremia, Young Adult