Hepatitis E virus and blood donors in Germany.

摘要

Adlhoch et al. recently reported a case of indigenous hepatitis E virus (HEV) infection in a German plasmapheresis donor [1]. Shortly after donation (24 h) the donor developed acute hepatitis which was reported to the health authorities. It was subsequently confirmed that the donor was infected with HEV. Analysis of archived plasma samples revealed that on the day of donation, the donor had elevated levels of alanine transaminase (ALT) of > 1000 IU/1 and was HEV RNA, anti-HEV IgM and anti-HEV IgG positive. In the proceeding 2 weeks, all markers were negative except for HEV RNA. In Germany, nucleic acid testing (NAT) is performed for HCV (and HIV-1) RNA, not for HEV RNA. Mandatory ALT testing was suspended in 2003, being considered to be of limited benefit for transfusion-relevant viruses [2]. However, under the previous requirements, the elevated levels of ALT observed in this donor would have resulted in deferral, at least for one of the donations. In nationwide studies in Japan, approximately 1.1% of donors with elevated ALT (> 200 IU/1) were HEV RNA positive, usually correlating with anti-HEV IgM, with significantly higher prevalence/incidence observed around Hokkaido [3].