title: Hepatitis E virus in the countries of the Middle East and North Africa region: an awareness of an infectious threat to blood safety.
abstract: OBJECTIVE
  Hepatitis E virus (HEV) is mainly transmitted through contaminated water supplies which make the virus endemic in developing countries including countries of the Middle East and North Africa (MENA) region. Recent reports suggest potential risk of HEV transmission via blood transfusion.
  
  
  METHODS
  Related articles on HEV were collected by searching through the 25 countries of the MENA region using Pubmed and Medline within the past 14 years: January 2000-August 2014.
  
  
  RESULTS
  One hundred articles were extracted, of which 25 were not eligible. The articles discussed the seroprevalence of HEV and HEV markers in 12 countries. Eight articles provided data on HEV in blood donors. The seroprevalence of HEV in the general MENA population ranged from 2.0 to 37.5% and was higher in males than in females. Prevalence increased with age, but exposure seems to be in early life.
  
  
  CONCLUSIONS
  In the MENA region, the role of HEV as an infectious threat to blood safety is under-investigated. More data are needed to quantify the risk of transmission and to assess clinical outcomes. This requires, at least, surveillance screening of donors and recipients for HEV markers using sensitive and specific serological tests. At the present time, serious consideration should be given to selective screening for certain groups of patients (e.g., immunocompromised, pregnant women and others) who commonly require blood transfusion and are at high risk of hepatic failure or chronicity from HEV infection.
authors.affiliation: Department of Medical Laboratory Sciences, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
authors.forename: Soha
authors.initials: S
authors.lastname: Yazbek
authors.affiliation: Department of Medical Laboratory Sciences, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
authors.forename: Khalil
authors.initials: K
authors.lastname: Kreidieh
authors.affiliation: Department of Medical Laboratory Sciences, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon. sramia@aub.edu.lb.
authors.forename: Sami
authors.initials: S
authors.lastname: Ramia
mesh_terms: D000352:Africa, Northern / Q000453:epidemiology; D001364:Awareness; D001769:Blood / Q000821:virology*; D058731:Blood Safety; D016751:Hepatitis E / Q000453:epidemiology*; D016752:Hepatitis E virus / Q000302:isolation & purification*; D006801:Humans; D008877:Middle East / Q000453:epidemiology; D016036:Seroepidemiologic Studies
keywords: Blood donors; Blood safety; Epidemiology; HEV; Hepatitis E; MENA region