Low Hepatitis E Virus Prevalence Among Blood Donor in Dali in China

Abstract BACKGROUND: Hepatitis E virus (HEV) is a nonenveloped RNA virus causing Hepatitis E worldwide. An increasing transfusion transmission cases of HEV infections from asymptomatic blood donors which causing serious illnesses in immunosuppressed recipients have been reported in the past few years. China is one of the highly prevalent regions of HEV, it is important to evaluate the risk of HEV transmission from blood transfusion. METHODS: A total of 1864 serum samples from blood donors and demographic characteristics were randomly collected from Feb to Mar 2018 in Dali city. Anti-HEV IgG, IgM and IgA antibodies and HEV antigen were examined by enzyme-linked immunosorbent assay (ELISA). HEV RNA was detected by real-time PCR. Multivariable logistic regression modelling was used to examine risk factors associated with HEV prevalence.RESULTS: Overall, the positive rate of anti-HEV IgG, IgM, and IgA antibodies was 13.36% (249/1864), 1.13%(21/1864), and 1.82%(34/1864), respectively. However, none of the 1864 serum samples was detected as HEV antigen-positive nor HEV RNA positive. The positive rate of anti-HEV IgG antibody is high as 28.57% (2/7) in the donors with isolated elevated alanine aminotransferase (ALT). Females (16.69%) had a significantly higher HEV seroprevalence than males (13.04%) (odds ratio [OR]: 1.34 [95% CI, 1.02-1.75]). Other ethnic minority (24.32%) and Bai (18.85%) donors had a significantly higher HEV seroprevalence when compared to Han (12.21%) blood donors (odds ratio [OR], 2.25 [95% CI, 1.04-4.88] for other ethnic minority, 1.65 [95% CI, 1.24-2.19] for Bai). Conclusions: Dali, Yunnan province, China is an endemic region for HEV and have a relatively low risk of HEV transmission via blood transfusion. Whether to formulate the strategy for HEV screening in blood center needed further researched.