Transfusion-Transmitted Hepatitis E and Implications for Blood Donation Screening: A Narrative Review

Abstract

Hepatitis E, which is caused by infection with the hepatitis E virus (HEV), is common in places with poor sanitation. HEV belongs to the Hepeviridae family, genus Orthohepevirus, and is an RNA virus. Over the past 19 years, cases of HEV transmitted by transfusions have been reported. Growing apprehension regarding the transmission of hepatitis E virus (HEV) through blood transfusions has emerged as a burgeoning global health concern. Individuals with compromised immune systems who contract HEV may experience a protracted infection, elevating their susceptibility to the development of liver cirrhosis and, ultimately, facing mortality. HEV can be transmitted at even relatively low blood levels of the virus. The usefulness of HEV testing on all blood donors is still up for debate. Some countries have implemented universal screening of HEV after taking risk and resource availability into account. The key approach for prevention is the HEV NAT screening. Alternative approaches, such as NAT testing for all or portion of blood donations individually or in a small pool, are being investigated. Future research is required to determine the incidence of HEV transmission by transfusion as well as its clinical characteristics, prognosis, and consequences. This article reviews the available data on transfusion-transmitted HEV, summarizes the prevalence of HEV infections among blood donors, and discusses the significance of these findings for blood donor screening. The review is based on a structured literature search using electronic databases, including Medline, Embase, Scopus, PubMed, Directory of Open Access Journals, and Web of Science. The literature search was accomplished in the databases already stated above using the keywords (HEV OR Hepatitis E Virus), (Blood Transfusion), (Transfusion-Transmitted), (Blood Safety), AND (Donor Screening).