EPIDEMIOLOGY OF HEPATITIS E VIRUS INFECTION IN A COHORT OF 4,023 IMMUNOCOMPROMISED PATIENTS.
Harritshøj LH., Hother CE., Sengeløv H., Daugaard G., Sørensen SS., Jacobsen S., Perch M., Holm DK., Sækmose SG., Aagaard B., Erikstrup C., Hogema BM., Lundgren JD., Ullum H.
OBJECTIVES:The prevalence of active, chronic and former hepatitis E virus (HEV) infections in a cohort of immunocompromised patients was investigated, the association with transfusion transmitted (TT) HEV was evaluated, and the HEV seroprevalence was compared with healthy blood donors. STUDY DESIGN AND METHODS:Serum samples from 4,023 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 using a multivariable logistic regression analysis. Samples from 1,226 blood donors were retrospectively tested for anti-HEV IgG. RESULTS:HEV RNA was detected in 6 patients (0.15%) with no indications of chronic HEV infections. 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. TT-infections were refuted, and transfusion history was not associated with anti-HEV positivity. HEV seroprevalence difference between patients (22.0%) and blood donors (10.9%) waned when adjusting for age and sex (odds ratio 1.20; CI 0.97-1.48). CONCLUSION:HEV viremia among allo-HSCT and SOT recipients suggests that clinicians should be aware of this diagnosis. No association of blood transfusion with anti-HEV positivity support that food borne transmission is the main transmission route of HEV common to both patients and blood donors.