A nationwide retrospective study on prevalence of hepatitis E virus infection in Italian blood donors

Research output: Contribution to journalArticle

Abstract

BACKGROUND: In Europe, hepatitis E virus (HEV) infection is mainly a food-borne zoonosis, but it can also be transmitted by blood transfusion. It is usually a mild and self-limited infection. However, immunocompromised persons, who are also those more likely to undergo blood transfusions, may develop chronic hepatitis and often cirrhosis. Since this is a potential threat to blood safety, we aimed to investigate HEV prevalence in Italian blood donors.

MATERIALS AND METHODS: We used plasma donations collected during 2015-2016 by blood services (BS) scattered throughout the Italian regions and intended for the production of plasma-derived medicines. Plasma samples were tested for IgG and IgM anti-HEV and for HEV RNA using validated assays. Data concerning donor's age and sex, and the location of the BS were collected.

RESULTS: A total of 10,011 plasma samples were tested. Overall IgG and IgM prevalence rates were 8.7 and 0.4%, respectively. No sample was HEV RNA-positive. IgG prevalence was significantly higher in males and in donors aged 44 years and over. IgG prevalence differed greatly according to region. Overall regional rates over 15% were found in Abruzzo and in Sardinia, and rates of 10-15% were found in Lazio, Umbria and the Marche. Considering IgG prevalence according to the province where the BS was located, rates over 30% were found in Sardinia and Abruzzo. Age, sex and donor's region of residence were independently associated with IgG positivity. BS location produced significant heterogeneity on prevalence rates within the regions.

DISCUSSION: The detected IgG rate of 8.7% in this study represents one of the lowest seroprevalence rates reported among blood donors in Europe. Particularly high prevalence rates in some regions and provinces may be explained by local eating habits and/or intensive environmental HEV contamination. Before considering the introduction of HEV RNA screening for blood donations in Italy, further important issues should be addressed and prospective incidence and reliable cost-benefit studies are needed.

Original languageEnglish
Pages (from-to)413-421
Number of pages9
JournalBlood transfusion = Trasfusione del sangue
Volume16
Issue number5
DOIs
Publication statusPublished - Sep 2018

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Hepatitis E virus
Virus Diseases
Blood Donors
Retrospective Studies
Immunoglobulin G
Italy
Tissue Donors
RNA
Blood Transfusion
Blood Safety
Seroepidemiologic Studies
Zoonoses
Feeding Behavior
Chronic Hepatitis
Cost-Benefit Analysis
Immunoglobulin M
Fibrosis
Food
Incidence
Infection

Keywords

  • Adult
  • Blood Donors
  • Blood Transfusion
  • Female
  • Hepatitis Antibodies/blood
  • Hepatitis E/blood
  • Hepatitis E virus
  • Humans
  • Immunoglobulin G/blood
  • Immunoglobulin M/blood
  • Italy/epidemiology
  • Liver Cirrhosis/blood
  • Male
  • Prevalence
  • RNA, Viral/biosynthesis
  • Retrospective Studies
  • Young Adult

Cite this

@article{f6771cc4e4de4d31982eb2c2b10187cc,
title = "A nationwide retrospective study on prevalence of hepatitis E virus infection in Italian blood donors",
abstract = "BACKGROUND: In Europe, hepatitis E virus (HEV) infection is mainly a food-borne zoonosis, but it can also be transmitted by blood transfusion. It is usually a mild and self-limited infection. However, immunocompromised persons, who are also those more likely to undergo blood transfusions, may develop chronic hepatitis and often cirrhosis. Since this is a potential threat to blood safety, we aimed to investigate HEV prevalence in Italian blood donors.MATERIALS AND METHODS: We used plasma donations collected during 2015-2016 by blood services (BS) scattered throughout the Italian regions and intended for the production of plasma-derived medicines. Plasma samples were tested for IgG and IgM anti-HEV and for HEV RNA using validated assays. Data concerning donor's age and sex, and the location of the BS were collected.RESULTS: A total of 10,011 plasma samples were tested. Overall IgG and IgM prevalence rates were 8.7 and 0.4{\%}, respectively. No sample was HEV RNA-positive. IgG prevalence was significantly higher in males and in donors aged 44 years and over. IgG prevalence differed greatly according to region. Overall regional rates over 15{\%} were found in Abruzzo and in Sardinia, and rates of 10-15{\%} were found in Lazio, Umbria and the Marche. Considering IgG prevalence according to the province where the BS was located, rates over 30{\%} were found in Sardinia and Abruzzo. Age, sex and donor's region of residence were independently associated with IgG positivity. BS location produced significant heterogeneity on prevalence rates within the regions.DISCUSSION: The detected IgG rate of 8.7{\%} in this study represents one of the lowest seroprevalence rates reported among blood donors in Europe. Particularly high prevalence rates in some regions and provinces may be explained by local eating habits and/or intensive environmental HEV contamination. Before considering the introduction of HEV RNA screening for blood donations in Italy, further important issues should be addressed and prospective incidence and reliable cost-benefit studies are needed.",
keywords = "Adult, Blood Donors, Blood Transfusion, Female, Hepatitis Antibodies/blood, Hepatitis E/blood, Hepatitis E virus, Humans, Immunoglobulin G/blood, Immunoglobulin M/blood, Italy/epidemiology, Liver Cirrhosis/blood, Male, Prevalence, RNA, Viral/biosynthesis, Retrospective Studies, Young Adult",
author = "Enea Spada and Simonetta Pupella and Giulio Pisani and Roberto Bruni and Paola Chionne and Elisabetta Madonna and Umbertina Villano and Matteo Simeoni and Sara Fabi and Giuseppe Marano and Cinzia Marcantonio and Patrizio Pezzotti and Ciccaglione, {Anna R} and Liumbruno, {Giancarlo M}",
year = "2018",
month = "9",
doi = "10.2450/2018.0033-18",
language = "English",
volume = "16",
pages = "413--421",
journal = "Blood Transfusion",
issn = "1723-2007",
publisher = "Edizioni SIMTI",
number = "5",

}

TY - JOUR

T1 - A nationwide retrospective study on prevalence of hepatitis E virus infection in Italian blood donors

AU - Spada, Enea

AU - Pupella, Simonetta

AU - Pisani, Giulio

AU - Bruni, Roberto

AU - Chionne, Paola

AU - Madonna, Elisabetta

AU - Villano, Umbertina

AU - Simeoni, Matteo

AU - Fabi, Sara

AU - Marano, Giuseppe

AU - Marcantonio, Cinzia

AU - Pezzotti, Patrizio

AU - Ciccaglione, Anna R

AU - Liumbruno, Giancarlo M

PY - 2018/9

Y1 - 2018/9

N2 - BACKGROUND: In Europe, hepatitis E virus (HEV) infection is mainly a food-borne zoonosis, but it can also be transmitted by blood transfusion. It is usually a mild and self-limited infection. However, immunocompromised persons, who are also those more likely to undergo blood transfusions, may develop chronic hepatitis and often cirrhosis. Since this is a potential threat to blood safety, we aimed to investigate HEV prevalence in Italian blood donors.MATERIALS AND METHODS: We used plasma donations collected during 2015-2016 by blood services (BS) scattered throughout the Italian regions and intended for the production of plasma-derived medicines. Plasma samples were tested for IgG and IgM anti-HEV and for HEV RNA using validated assays. Data concerning donor's age and sex, and the location of the BS were collected.RESULTS: A total of 10,011 plasma samples were tested. Overall IgG and IgM prevalence rates were 8.7 and 0.4%, respectively. No sample was HEV RNA-positive. IgG prevalence was significantly higher in males and in donors aged 44 years and over. IgG prevalence differed greatly according to region. Overall regional rates over 15% were found in Abruzzo and in Sardinia, and rates of 10-15% were found in Lazio, Umbria and the Marche. Considering IgG prevalence according to the province where the BS was located, rates over 30% were found in Sardinia and Abruzzo. Age, sex and donor's region of residence were independently associated with IgG positivity. BS location produced significant heterogeneity on prevalence rates within the regions.DISCUSSION: The detected IgG rate of 8.7% in this study represents one of the lowest seroprevalence rates reported among blood donors in Europe. Particularly high prevalence rates in some regions and provinces may be explained by local eating habits and/or intensive environmental HEV contamination. Before considering the introduction of HEV RNA screening for blood donations in Italy, further important issues should be addressed and prospective incidence and reliable cost-benefit studies are needed.

AB - BACKGROUND: In Europe, hepatitis E virus (HEV) infection is mainly a food-borne zoonosis, but it can also be transmitted by blood transfusion. It is usually a mild and self-limited infection. However, immunocompromised persons, who are also those more likely to undergo blood transfusions, may develop chronic hepatitis and often cirrhosis. Since this is a potential threat to blood safety, we aimed to investigate HEV prevalence in Italian blood donors.MATERIALS AND METHODS: We used plasma donations collected during 2015-2016 by blood services (BS) scattered throughout the Italian regions and intended for the production of plasma-derived medicines. Plasma samples were tested for IgG and IgM anti-HEV and for HEV RNA using validated assays. Data concerning donor's age and sex, and the location of the BS were collected.RESULTS: A total of 10,011 plasma samples were tested. Overall IgG and IgM prevalence rates were 8.7 and 0.4%, respectively. No sample was HEV RNA-positive. IgG prevalence was significantly higher in males and in donors aged 44 years and over. IgG prevalence differed greatly according to region. Overall regional rates over 15% were found in Abruzzo and in Sardinia, and rates of 10-15% were found in Lazio, Umbria and the Marche. Considering IgG prevalence according to the province where the BS was located, rates over 30% were found in Sardinia and Abruzzo. Age, sex and donor's region of residence were independently associated with IgG positivity. BS location produced significant heterogeneity on prevalence rates within the regions.DISCUSSION: The detected IgG rate of 8.7% in this study represents one of the lowest seroprevalence rates reported among blood donors in Europe. Particularly high prevalence rates in some regions and provinces may be explained by local eating habits and/or intensive environmental HEV contamination. Before considering the introduction of HEV RNA screening for blood donations in Italy, further important issues should be addressed and prospective incidence and reliable cost-benefit studies are needed.

KW - Adult

KW - Blood Donors

KW - Blood Transfusion

KW - Female

KW - Hepatitis Antibodies/blood

KW - Hepatitis E/blood

KW - Hepatitis E virus

KW - Humans

KW - Immunoglobulin G/blood

KW - Immunoglobulin M/blood

KW - Italy/epidemiology

KW - Liver Cirrhosis/blood

KW - Male

KW - Prevalence

KW - RNA, Viral/biosynthesis

KW - Retrospective Studies

KW - Young Adult

U2 - 10.2450/2018.0033-18

DO - 10.2450/2018.0033-18

M3 - Article

C2 - 29757135

VL - 16

SP - 413

EP - 421

JO - Blood Transfusion

JF - Blood Transfusion

SN - 1723-2007

IS - 5

ER -