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Transfusion-Transmitted Hepatitis E Virus Infection in France.

Pierre Gallian1, Elodie Pouchol2, Rachid Djoudi2

  • 1Etablissement Français du Sang, La Plaine St Denis, France; Unité des virus émergents (Université Aix-Marseille, IRD 90, U 1207 Inserm), IHU Méditerranée Infection, Marseille, France.

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Summary

Transfusion-transmitted hepatitis E is a growing risk, especially for immunocompromised patients. This study found that blood products like red cells, platelets, and plasma can transmit hepatitis E virus (HEV), potentially leading to chronic infection.

Keywords:
Hepatitis EHepatitis E virusTransfusion-transmitted infection

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Area of Science:

  • Infectious Diseases
  • Hepatology
  • Transfusion Medicine

Background:

  • Hepatitis E virus (HEV) poses a risk for transfusion-transmitted (TT) infections.
  • Cases of TT hepatitis E have been reported in France since 2006.

Purpose of the Study:

  • To analyze the incidence and characteristics of TT hepatitis E cases in France between 2006 and 2016.
  • To assess the outcomes of TT hepatitis E in transfusion recipients.

Main Methods:

  • Retrospective analysis of TT hepatitis E cases reported to the French hemovigilance network (2006-2016).
  • Phylogenetic analysis to confirm high imputability of transfusion transmission.
  • Review of patient demographics, clinical outcomes, and treatments.

Main Results:

  • Twenty-three cases of TT hepatitis E with high imputability were identified.
  • Affected patients were primarily solid organ recipients and those with hematological malignancies.
  • Blood products implicated included plasma, red blood concentrates, and platelet concentrates, some treated with pathogen reduction.
  • Hepatitis E virus (HEV) infection progressed to chronic hepatitis E in 61% of immunocompromised patients.
  • Most patients eventually cleared HEV through treatment or spontaneously, but one patient died.

Conclusions:

  • Transfusion of red cells, platelets, and plasma can transmit HEV.
  • Immunocompromised patients are at risk for developing chronic hepatitis E post-transfusion.
  • HEV has emerged as a significant transfusion-transmitted infection risk in France.