Serological and molecular evidence of a plausible transmission of hepatitis E virus through pooled plasma

作者：Anton Andonov, G. Rock, Liangjie Lin, Jamie Borlang, John A. Hooper, Elsie Grudeski, Jun Wu, Members of the Canadian Apheresis Group (CAG) · 发表于：Vox Sanguinis · 年份：2014 · DOI：10.1111/vox.12156 · 被引用次数：42 · 研究领域：Hepatitis Viruses Studies and Epidemiology、Animal Virus Infections Studies、Hepatitis B Virus Studies

BACKGROUND AND OBJECTIVES: Recently, hepatitis E virus has been recognized as a new transfusion-associated risk; however, its efficiency of transmission through blood products requires further investigation. Asymptomatic viremia of short duration has been observed in blood donors from several European countries to the rate of <1:10,000 and HEV transmission in recipients of blood products has been documented in Japan and Europe. Although HEV RNA was detected in large plasma fractionation pools used for manufacturing of plasma derived products, HEV transmission has not been demonstrated so far. In this study, we investigated the possibility of HEV transmission in patients with thrombotic thrombocytopenic purpura whose treatment included up to 40 l of plasma exchange. MATERIALS AND METHODS: Thirty-six TTP patients received either solvent-detergent-treated plasma prepared by pooling of 2500 single-donor or cryosupernatant plasma. Three samples were collected from TTP patients at time 0, 1 and 6 months post-treatment and tested for anti-HEV antibodies. Patients with HEV seroconversion were also tested for viremia by PCR. RESULTS: Two of seventeen TTP patients treated with SDP showed serological evidence of HEV infection. The 1-month samples from these patients were also positive for HEV RNA. A distinct rise of anti-HEV IgG level was detected in two other TTP patients with weak pre-existing immunity to HEV; this observation is indicative of a possible immune response boost due to a...