title: Red blood cell transfusion-transmitted acute hepatitis E in an immunocompetent subject in Europe: a case report.
abstract: Acute hepatitis E in industrialized countries is usually related to intake or manipulation of undercooked or raw meat. Cases of transfusion-transmitted hepatitis E have rarely been documented in immunosuppressed patients, mainly after receiving frozen plasma.
  
  
  
  A 61-year-old man was admitted to hospital for jaundice. His personal history included disseminated bacillus Calmette-Guerin infection treated with antituberculous drugs. He had received red blood cell (RBC) transfusion 2 months previously, during admission for mycotic aneurysm surgery. Since liver function tests worsened despite stopping antituberculous drugs, other causes of acute hepatitis were explored.
  
  
  
  Acute hepatitis E was diagnosed by the presence of both immunoglobulin M and hepatitis E virus (HEV) RNA. Traceback procedure for the 8 RBC units was carried out, and one of the eight archive plasma samples tested positive for HEV RNA, with an estimated viral load of 75,000 IU/mL. Phylogenetic analysis revealed the same HEV strain Genotype 3 in one of the transfused RBC products and in the patient's serum sample.
  
  
  
  Transfusion of RBCs with detectable HEV RNA is a risk factor for acute hepatitis E in immunocompetent patients in Europe.
authors: Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d'Hebron and Universitat Autònoma de Barcelona, Barcelona, Spain.|Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.
authors: Mar
authors: M
authors: Riveiro-Barciela
authors: Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.|Transfusion Safety Laboratory, Banc de Sang i Teixits, Servei Català de la Salut.
authors: Silvia
authors: S
authors: Sauleda
authors: Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.|Liver Unit, Internal Medicine, Lab. Malalties Hepàtiques, Vall d'Hebron Institut Recerca-Hospital Universitari Vall d'Hebron (VHIR-HUVH).
authors: Josep
authors: J
authors: Quer
authors: Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, PROSICS Barcelona.
authors: Fernando
authors: F
authors: Salvador
authors: Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.|Liver Unit, Internal Medicine, Lab. Malalties Hepàtiques, Vall d'Hebron Institut Recerca-Hospital Universitari Vall d'Hebron (VHIR-HUVH).
authors: Josep
authors: J
authors: Gregori
authors: Transfusion Safety Laboratory, Banc de Sang i Teixits, Servei Català de la Salut.
authors: María
authors: M
authors: Pirón
authors: Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.|Liver Pathology Unit, Departments of Biochemistry and Microbiology (Virology Unit), Hospital Universitari Vall d'Hebron and Universitat Autònoma de Barcelona, Barcelona, Spain.
authors: Francisco
authors: F
authors: Rodríguez-Frías
authors: Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d'Hebron and Universitat Autònoma de Barcelona, Barcelona, Spain.|Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.
authors: Maria
authors: M
authors: Buti
mesh_terms: D000208:Acute Disease; D000785:Aneurysm, Infected / Q000097:blood / Q000382:microbiology / Q000628:therapy; D000914:Antibodies, Viral / Q000097:blood*; D017707:Erythrocyte Transfusion; D016751:Hepatitis E / Q000097:blood / Q000209:etiology / Q000235:genetics / Q000635:transmission; D016752:Hepatitis E virus / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009163:Mycobacterium bovis; D012367:RNA, Viral / Q000097:blood / Q000235:genetics; D014376:Tuberculosis / Q000097:blood / Q000382:microbiology / Q000628:therapy
chemical_list: D000914:Antibodies, Viral; D012367:RNA, Viral