Unique clinical courses of transfusion-transmitted hepatitis E in patients with immunosuppression.
Transfusion
; 57(2): 280-288, 2017 02.
Article
em En
| MEDLINE
| ID: mdl-28144952
ABSTRACT
BACKGROUND:
The high prevalence of specific immunoglobulin G for hepatitis E virus (HEV) in Japanese people raises the possibility of a high incidence of HEV-viremic blood donors and therefore frequent transfusion-transmitted HEV (TT-HEV). STUDY DESIGN ANDMETHODS:
TT-HEV cases established in Japan through hemovigilance and those published in the literature were collected. Infectivity of HEV-contaminated blood components and disease severity in relation to immunosuppression were investigated.RESULTS:
Twenty established TT-HEV cases were recorded over the past 17 years. A lookback study verified that five of 10 patients transfused with known HEV-contaminated blood components acquired HEV infection. The minimal infectious dose of HEV through transfusion was 3.6 × 104 IU. Nine of the 19 TT-HEV cases analyzed had hematologic diseases. Only two cases showed the maximal alanine aminotransferase level of more than 1000 U/L. Two patients with hematologic malignancy and two liver transplant recipients had chronic liver injury of moderate severity.CONCLUSION:
The infectivity of HEV-contaminated components was 50%. Immunosuppression likely causes the moderate illness of TT-HEV, but it may lead to the establishment of chronic sequelae. Transfusion recipients, a population that is variably immunosuppressed, are more vulnerable to chronic liver injury as a result of TT-HEV than the general population is as a result of food-borne infection.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doadores de Sangue
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Transfusão de Sangue
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Imunoglobulina G
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Terapia de Imunossupressão
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Vírus da Hepatite E
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Hepatite E
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Segurança do Sangue
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Anticorpos Antivirais
Tipo de estudo:
Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article