title: Rare case of transfusion-transmitted hepatitis E from the blood of a donor infected with the hepatitis E virus genotype 3 indigenous to Japan: Viral dynamics from onset to recovery.
abstract: OBJECTIVE
  The transfusion transmission of hepatitis E can occur even in non-endemic areas in the world as autochthonous hepatitis E has been increasingly reported in developed countries where the hepatitis E virus (HEV) is not prevalent. We investigated the post-transfusion transmission of hepatitis E in a patient by molecularly confirming its presence, and characterized the viral kinetics of HEV in this case.
  
  
  METHODS
  A Japanese man underwent re-thoracotomy for hemostasis followed by platelet transfusion. After the transfusion, the blood donor was found to be HEV positive. The donated blood was re-examined and was found to contain HEV. Throughout the prospective follow up of the patient, we analyzed the viral kinetics, chronological anti-HEV antibody level changes and disease progression during the entire course of HEV infection from transfusion until the end of viremia.
  
  
  RESULTS
  Sequence analysis of the strains isolated from both the donor and the patient who contracted acute hepatitis E showed an identical match for 326 nucleotides in open reading frame 1. Two strains belonged to HEV genotype 3 indigenous to Japan.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first detailed report on the entire natural course of hepatitis E from viral transmission, then clearance, to replication preceding liver injury caused by HEV genotype 3, which is responsible for autochthonous infection in developed countries. The findings provide valuable insights into the mechanism of the transfusion transmission of HEV and subsequent viral dynamics.
authors.affiliation: Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.|Department of Virology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Matsui
authors.affiliation: Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Jong-Hon
authors.initials: JH
authors.lastname: Kang
authors.affiliation: Japanese Red Cross Hokkaido Block Blood Center, Hokkaido, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Matsubayashi
authors.affiliation: Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Hajime
authors.identifier: http://orcid.org/0000-0002-9034-4370
authors.initials: H
authors.lastname: Yamazaki
authors.affiliation: Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Nagai
authors.affiliation: Japanese Red Cross Hokkaido Block Blood Center, Hokkaido, Japan.
authors.forename: Hidekatsu
authors.initials: H
authors.lastname: Sakata
authors.affiliation: Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Tsuji
authors.affiliation: Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Maguchi
keywords: genotype; hepatitis E virus; hepatitis E virus RNA; transfusion-transmitted hepatitis