title: [Assessment of a transfusion emergent risk: the case of HEV].
abstract: BACKGROUND
  The risk assessment for blood transfusion is an essential step that must precede any screening strategy of a pathogen transmitted by transfusion. After several cases of HEV transmission by transfusion in France, a risk assessment for this virus was performed.
  
  
  METHODS
  We used a method based on the prevalence of HEV-RNA in plasmas collected for the preparation of SD-plasma. To estimate the rate of HEV-RNA positive among all blood donations, data on SD-plasma were adjusted on the following HEV risk factors: gender, age group and region of residence. We assumed that HEV risk factors were the same in plasma donors and whole blood donors.
  
  
  RESULTS
  Among 57,101 plasma donations tested for HEV-RNA in 2013, 24 were positive (crude rate of 4.2 per 10,000 donations). After adjustment, the total number of HEV-RNA positive blood donations was estimated at 788, accounting for a rate of 2.65 per 10,000 donations (95% CI: 1.6-3.7) or 1 in 3800 donations (1 in 6,200-1 in 2,700). This rate was 12 times higher in men than in women, increased with age, and varied according to region of residence.
  
  
  CONCLUSIONS
  The risk of blood donation contamination by HEV has been estimated to be 1 in 3800 donations in 2013. An essential input is still missing to assess now the risk in recipients: the minimum infectious dose. Furthermore, the risk in recipients has to be analyzed according to characteristics of transfused patients: presence of anti-HEV immunity, existence of chronic liver disease or immunodeficiency.
authors.affiliation: Département des maladies infectieuses, institut de veille sanitaire, 12, rue du Val-d'Osne, 94410 Saint-Maurice, France. Electronic address: j.pillonel@invs.sante.fr.
authors.forename: J
authors.initials: J
authors.lastname: Pillonel
authors.affiliation: Établissement français du sang Alpes-Méditerranée, 13005 Marseille, France.
authors.forename: P
authors.initials: P
authors.lastname: Gallian
authors.affiliation: Département des maladies infectieuses, institut de veille sanitaire, 12, rue du Val-d'Osne, 94410 Saint-Maurice, France.
authors.forename: C
authors.initials: C
authors.lastname: Sommen
authors.affiliation: Département des maladies infectieuses, institut de veille sanitaire, 12, rue du Val-d'Osne, 94410 Saint-Maurice, France.
authors.forename: E
authors.initials: E
authors.lastname: Couturier
authors.affiliation: Établissement français du sang Aquitaine-Limousin, 33035 Bordeaux, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Piquet
authors.affiliation: Établissement français du sang, 93218 La Plaine Saint-Denis, France.
authors.forename: R
authors.initials: R
authors.lastname: Djoudi
authors.affiliation: Département d'études des agents transmissibles par le sang, centre national de référence pour les hépatites B et C et du VIH en transfusion, institut national de la transfusion sanguine, 75015 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Laperche
mesh_terms: D001782:Blood Donors; D058731:Blood Safety / Q000592:standards*; D021821:Communicable Diseases, Emerging / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D046148:Donor Selection; D005060:Europe / Q000453:epidemiology; D005260:Female; D005602:France / Q000453:epidemiology; D014943:Global Health; D016751:Hepatitis E / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D016752:Hepatitis E virus / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008297:Male; D010949:Plasma / Q000821:virology; D012367:RNA, Viral / Q000097:blood*; D012306:Risk; D018570:Risk Assessment / Q000379:methods*; D065227:Transfusion Reaction; D014766:Viremia / Q000175:diagnosis / Q000453:epidemiology / Q000635:transmission
chemical_list: D012367:RNA, Viral
keywords: Blood transfusion; HEV; Risk assessment; Transfusion sanguine; VHE; Évaluation de risque