Acute, Recent and Past HEV Infection among Voluntary Blood Donors in China: A Systematic Review and Meta-Analysis.
BACKGROUND
Hepatitis E virus is one of new threats to blood safety which was usually considered to be transmitted via fecal-oral route. China is one of the hyperendemic regions where frequent outbreaks of hepatitis E are noted. However, the overall prevalence of HEV infection among mainland Chinese blood donors is not clear until now.


METHODS
The peer-reviewed literatures reporting the prevalence of HEV in Chinese blood donors were identified by systematic searching of five electronic databases. The systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement issued in 2009. Data manipulation and statistical analyses were performed by Stata 12.0.


RESULTS
Fourteen eligible articles involving 22 independent studies were included. Pooled prevalence of HEV infection biomarkers (anti-HEV IgG, anti-HEV IgM, RNA and antigen) among mainland Chinese blood donors were 29.2%, 1.1%, 0.1% and 0.1%, respectively which were higher than the data reported in other countries. The analysis of HEV genotypes indicated that the most prevalent strains in Chinese blood donors were genotype 1 and 4.


CONCLUSIONS
Mainland China is indicated with a relatively higher risk of transmission of hepatitis E through transfusion and the screening of blood donors for HEV RNA, especially in HEV-endemic areas, might reduce the potential risk of HEV infection via transfusion.
Institute of Blood Transfusion, Chinese Academy of Medical Sciences, HuaCai Road 26 Hao, Dong San Huan Road ErDuan, Chengdu, Sichuan, China.
Meiyu
M
Wang
Institute of Blood Transfusion, Chinese Academy of Medical Sciences, HuaCai Road 26 Hao, Dong San Huan Road ErDuan, Chengdu, Sichuan, China.
Ping
P
Fu
Institute of Blood Transfusion, Chinese Academy of Medical Sciences, HuaCai Road 26 Hao, Dong San Huan Road ErDuan, Chengdu, Sichuan, China.
Yonghua
Y
Yin
Institute of Blood Transfusion, Chinese Academy of Medical Sciences, HuaCai Road 26 Hao, Dong San Huan Road ErDuan, Chengdu, Sichuan, China.
Miao
M
He
Institute of Blood Transfusion, Chinese Academy of Medical Sciences, HuaCai Road 26 Hao, Dong San Huan Road ErDuan, Chengdu, Sichuan, China.
Yu
Y
Liu
D015415:Biomarkers / Q000097:blood*; D001782:Blood Donors; D058731:Blood Safety; D002681:China; D006508:Hepatitis Antibodies / Q000097:blood; D016751:Hepatitis E / Q000097:blood* / Q000453:epidemiology* / Q000635:transmission / Q000821:virology; D016752:Hepatitis E virus / Q000302:isolation & purification / Q000472:pathogenicity; D006801:Humans
D015415:Biomarkers; D006508:Hepatitis Antibodies