@article{d03438db16884db0a3d977151741b404,
title = "Probable transmission of hepatitis E virus (HEV) via transfusion in the United States",
abstract = "BACKGROUND: Hepatitis E virus (HEV) can inapparently infect blood donors. To assess transfusion transmission of HEV in the United States, which has not been documented, a donor-recipient repository was evaluated. STUDY DESIGN AND METHODS: To identify donations that contained HEV RNA and were linked to patient-recipients with antibody evidence of HEV exposure, we assayed samples from the Retrovirus Epidemiology Donor Study (REDS) Allogeneic Donor and Recipient repository that represents 13,201 linked donations and 3384 transfused patients. Posttransfusion samples, determined to contain IgG anti-HEV by enzyme-linked immunosorbent assay, were reassayed along with corresponding pretransfusion samples for seroconversion (incident exposure) or at least fourfold IgG anti-HEV increase (reexposure). HEV-exposed patients were linked to donations in which HEV RNA was then detected by reverse-transcription quantitative polymerase chain reaction, confirmed by transcription-mediated amplification, and phylogenetically analyzed as subgenomic cDNA sequences. RESULTS: Among all patients, 19 of 1036 (1.8%) who had IgG anti-HEV before transfusion were reexposed; 40 of 2348 (1.7%) without pretransfusion IgG anti-HEV seroconverted. These 59 patients were linked to 257 donations, 1 of which was positive by reverse-transcription quantitative polymerase chain reaction and transcription-mediated amplification. Plasma from this donation contained 5.5 log IU/mL of HEV RNA that grouped with HEV genotype 3, clade 3abchij. The patient-recipient of RBCs from this donation had a greater than eightfold IgG increase; however, clinical data are unavailable. CONCLUSIONS: This is the first report of probable HEV transmission via transfusion in the United States, although it has been frequently observed in Europe and Japan. Additional data on the magnitude of the risk in the United States are needed.",
author = "Ticehurst, {John R.} and Nora Pisanic and Forman, {Michael S.} and Carly Ordak and Heaney, {Christopher D.} and Edgar Ong and Linnen, {Jeffrey M.} and Ness, {Paul M.} and Nan Guo and Hua Shan and Nelson, {Kenrad E.}",
note = "Funding Information: From the 1Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland; 2Division of Infectious Diseases, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland; 3Division of Medical Microbiology, Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland; 4Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland; 5Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland; 6Hologic Inc, San Diego, California; 7Division of Transfusion Medicine, Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland; 8Division of Oncology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland; and the 9Department of Transfusion Medicine, Stanford University, Palo Alto, California. Address reprint requests to: in lieu of initial corresponding author Kenrad Nelson, John Ticehurst, Division of Medical Microbiology, Department of Pathology, Meyer B-130, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287; e-mail: jticehur@jhmi.edu This work was supported by grant R21 HL121740 from NHLBI, NIH. CDH was supported by E.W. “Al” Thrasher Award 10287 from the Thrasher Research Fund; grant 1316318 from NSF as part of the joint NSF-NIH-USDA Ecology and Evolution of Infectious Diseases program; grant K01OH010193 from NIOSH, CDC; and grant R01ES026973 NIEHS, NIH. Funding Information: We thank Robin Cory, Tim Shin, Anh Hoang, and Graham Anderson for their technical assistance. We also acknowledge BioLINCC and NHLBI staff for considering and fulfilling our requests. Publisher Copyright: {\textcopyright} 2019 AABB",
year = "2019",
month = mar,
doi = "10.1111/trf.15140",
language = "English (US)",
volume = "59",
pages = "1024--1034",
journal = "Transfusion",
issn = "0041-1132",
publisher = "Wiley-Blackwell",
number = "3",
}