title: High prevalence of anti-hepatitis E virus antibodies among blood donors in central Italy, February to March 2014.
abstract: Prevalence of anti-hepatitis E virus (HEV) antibodies is highly variable in developed countries, which seems partly due to differences in assay sensitivity. Using validated sensitive assays, we tested 313 blood donors attending a hospital transfusion unit in central Italy in January and February 2014 for anti-HEV IgG and IgM and HEV RNA. Data on HEV exposure were collected from all donors. Overall anti-HEV IgG prevalence was 49% (153/313). Eating raw dried pig-liver sausage was the only independent predictor of HEV infection (adjusted prevalence rate ratio = 2.14; 95% confidence interval: 1.23-3.74). Three donors were positive for either anti-HEV IgM (n = 2; 0.6%) or HEV RNA (n = 2; 0.6%); they were completely asymptomatic, without alanine aminotransferase (ALT) abnormalities. Of the two HEV RNA-positive donors (both harbouring genotype 3), one was anti-HEV IgG- and IgM-positive, the other was anti-HEV IgG- and IgM-negative. The third donor was positive for anti-HEV IgG and IgM but HEV RNA-negative. HEV infection is therefore hyperendemic among blood donors (80% men 18-64 years-old) from central Italy and associated with local dietary habits. Nearly 1% of donors have acute or recent infection, implying potential transmission to blood recipients. Neither ALT nor anti-HEV IgM testing seems useful to prevent transfusion-transmitted HEV infection.
authors: Department of Infectious Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Rome, Italy.
authors: Claudia
authors: C
authors: Lucarelli
authors: Enea
authors: E
authors: Spada
authors: Gloria
authors: G
authors: Taliani
authors: Paola
authors: P
authors: Chionne
authors: Elisabetta
authors: E
authors: Madonna
authors: Cinzia
authors: C
authors: Marcantonio
authors: Patrizio
authors: P
authors: Pezzotti
authors: Roberto
authors: R
authors: Bruni
authors: Giuseppina
authors: G
authors: La Rosa
authors: Giulio
authors: G
authors: Pisani
authors: Luigi
authors: L
authors: Dell'Orso
authors: Katia
authors: K
authors: Ragone
authors: Carla
authors: C
authors: Tomei
authors: Anna Rita
authors: AR
authors: Ciccaglione
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001782:Blood Donors; D001803:Blood Transfusion; D005260:Female; D005838:Genotype; D006508:Hepatitis Antibodies / Q000097:blood*; D016751:Hepatitis E / Q000097:blood / Q000453:epidemiology* / Q000635:transmission; D016752:Hepatitis E virus / Q000145:classification* / Q000235:genetics / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D017422:Sequence Analysis, DNA; D055815:Young Adult
chemical_list: D006508:Hepatitis Antibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D012367:RNA, Viral
keywords: Italy; blood donors; hepatitis E virus; prevalence; risk factors; zoonotic infections