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Early hepatitis E infection in an unrelated hematopoietic progenitor stem cell donor

Bone Marrow Transplantation volume 52, pages 1471–1472 (2017)Cite this article

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Infection with Hepatitis E virus (HEV) is usually an asymptomatic, self-limiting illness. However, persistent infection and chronic hepatitis leading to cirrhosis can occur in immunocompromised individuals. In Europe, HEV infection is a zoonotic disease predominantly caused by HEV Genotype 3.1 Chronic HEV infection has been reported both in recipients of solid organs and of hematopoietic progenitor cells (HPC).2, 3 As a result, transfusion services have investigated local HEV seroprevalence to aid in the risk-assessment for donor screening. Variable HEV seroprevalence has been identified ranging from 27% in the Netherlands to 4.7% in Scotland (anti-HEV IgG).4, 5 The Irish blood transfusion Service (IBTS) identified the seroprevalence of HEV in the Republic of Ireland blood donor population at the lower end of the range at 5.3% and the prevalence of HEV viremia at 1 in 5000 donations. The IBTS initiated a program of screening all blood donors by individual-donation Nucleic Acid Testing (ID-NAT) for HEV RNA from January 2016.6 The Irish Unrelated Bone Marrow Registry (IUBMR) is hosted by the IBTS and facilitates HPC transplants for national and international patients. The IUBMR is subject to the IBTS quality system, testing protocols, including infectious disease markers. We report a case of Hepatitis E viraemia in an unrelated peripheral blood stem cell (PBSC) donor detected on the day of donation.

A 38-year-old healthy male volunteer unrelated donor on the Irish registry was identified as a fully histo compatible match for an international patient in need of a peripheral blood stem cell transplant. In addition to volunteering to be listed on the registry, the donor was also an unremunerated blood donor and had donated several times in the past. Upon selection for work-up, the donor attended for counselling, including infectious disease testing prior to final clearance to donate. The donor was healthy with normal physical examination. Complete blood count, renal and liver function was within normal limits. Test results for hepatitis B virus (HBV)DNA, hepatitis C virus (HCV) and HIV RNA on the Panther platform (Grifols/Hologic) using the Procleix Ultrio Elite assay (Grifols) by single donation testing were negative. ID-NAT for HEV (Procleix HEV assay) was also negative. Serological tests for HBV surface Ag, hepatitis B core Ab, HCV Ab, HIV 1 +2 Ag/Ab, CMV, Syphilis, Toxoplasma and HTLV 1+2 IgG were all negative.

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  1. Irish Blood Transfusion Service, Dublin, Ireland

    D O’Donghaile, N O’Flaherty & S Field

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  1. D O’Donghaile
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  2. N O’Flaherty
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Correspondence to D O’Donghaile.

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O’Donghaile, D., O’Flaherty, N. & Field, S. Early hepatitis E infection in an unrelated hematopoietic progenitor stem cell donor. Bone Marrow Transplant 52, 1471–1472 (2017). https://doi.org/10.1038/bmt.2017.163

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