Hepatitis E virus infection in the Irish blood donor population.

BACKGROUND: Hepatitis E virus (HEV) Genotype 3 (G3) infection is a zoonosis that may be transmitted during the acute phase by transfusion. The aim of this study was to determine the incidence of HEV and seroprevalence among Irish blood donors. STUDY DESIGN AND METHODS: Anonymized samples from 1076 donations collected in 2012 were tested for HEV immunoglobulin (Ig)G using the Wantai enzyme-linked immunosorbent assay. A total of 24,985 anonymized donations collected between December 2013 and June 2014 were individually tested for HEV RNA using the Procleix HEV assay; reactive donations were confirmed by an in-house real-time polymerase chain reaction (PCR) test. RESULTS: Seroprevalence for anti-IgG was 5.3% (95% confidence interval [CI], 4.0%-6.8%), ranging from 1.1% in the 18- to 29-years age group to 33.3% in males over 60 years. HEV RNA screening of 24,985 samples yielded five PCR-confirmed donations (1:4997, 0.02%; 95% CI, 0.0065%-0.0467%), only one of which was serologically reactive (HEV IgM reactive only). Viral loads ranged from 10 to 44,550 IU/mL. Genotype analysis on three samples identified HEV G3 virus. Four of the five viremic donations were from donors in the 18- to 29-years age group (p = 0.01). CONCLUSION: Seroprevalence for anti-HEV IgG was low compared to some European countries, but 1 in 5000 donations was viremic. Viremia was predominantly in younger Irish donors. After Department of Health approval the Irish Blood Transfusion Service implemented individual blood donation HEV RNA screening initially for a 3-year period from January 2016.

Outcome of an optional HCV screening program for blood transfusion recipients in Ireland.

BACKGROUND: An optional (general) HCV testing program for blood and blood component recipients before the introduction of routine donor anti-HCV screening (October 1991) was launched in Ireland in 1995 to complement the targeted lookback program in progress at that time and to identify transfusion-transmitted hepatitis C. STUDY DESIGN AND METHODS: The public were informed of the opportunity to avail of screening by widespread media coverage. Screening was by an initial ELISA (Abbott 3.0, Abbott Laboratories) at the transfusion center laboratories. Reactive samples were referred to a virus reference laboratory where two additional ELISAs (Ortho 3.0, Ortho Clinical Diagnostics; and Murex 3.0, Murex) were performed. Confirmation of ELISA-positive samples was by a RIBA (RIBA 3.0, Chiron Corp.). All patients found to be anti-HCV- seropositive were tested for HCV RNA by PCR and were referred to a hepatologist. RESULTS: A total of 14,917 persons have been tested for hepatitis C in this program to date (85% women). Sixty-one people were confirmed positive for HCV by RIBA 3.0 (0.4%). Excluding persons with other risk factors (n = 15), the HCV positivity rate for blood component transfusion recipients (n = 46) was 0.3 percent. Of the 46 confirmed hepatitis C-positive blood component transfusion recipients, 32 were women (70%), 24 of whom received transfusion for obstetric or gynecologic indications (75%). Thirty-eight of 46 (83%) anti-HCV seropositive transfusion recipients tested had detectable HCV RNA by PCR. CONCLUSION: This program identified 46 transfusion recipients and 10 coagulation factor concentrate recipients, all of whom were previously unaware of their infection. The majority of HCV-positive transfusion recipients identified were women. This may reflect that women are longer living survivors of transfusion therapy or alternatively, in our experience, that Irish women perceive themselves at greater risk of hepatitis C because of the well-publicized association of this virus with recipients (women) of Irish RhIG.