Assessing an emerging transfusion risk: the example of HEV

Objective: Transfusion risk assessment is an essential step that must precede any screening strategy for a transfusion-transmissible pathogen. Following the occurrence of several cases of HEV transmission via transfusion in France, a risk assessment for this virus was conducted. Method: we used a method based on the prevalence of HEV RNA in plasma donations used for the preparation of PFC-SD plasma. To estimate this prevalence across all donations, the data were adjusted for HEV risk factors (sex, age, and region of residence), assuming that these factors were identical among plasma and whole blood donors. Results: Among the 57,101 plasma donations tested in 2013, 24 were HEV-RNA positive (crude rate of 4.2 per 10,000 donations). After adjustment, the total number of HEV-RNA-positive blood donations was estimated at 788, representing a rate of 2.65 per 10,000 donations (95% CI: 1.6–3.7) or 1 in 3,800 donations (1 in 6,200–1 in 2,700). This rate is 12 times higher in men than in women, increases with age, and varies by region. Conclusion: the risk of HEV contamination in a blood donation was estimated at 1 per 3,800 donations in 2013. A key piece of data is still missing to assess this risk in recipients at this time: the minimum infectious dose. Furthermore, this recipient risk must be assessed based on the characteristics of transfusion recipients: presence of anti-HEV immunity, existence of chronic liver disease, or immunodeficiency. (R.A.)

Author(s): Pillonel J, Gallian P, Sommen C, Couturier E, Piquet Y, Djoudi R, Laperche S

Publishing year: 2014

Pages: 162-6

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