Adlhoch C, Kaiser M, Pauli G, Koch J, Meisel H (2009): Indigenous hepatitis E virus infection of a plasma donor in Germany
Vox Sang. 97 (4): 303-308. Epub 25 Jun.

Background Although Europe is supposed to be non-endemic for Hepatitis E virus (HEV), locally acquired human cases are registered, and a relatively high prevalence for anti-HEV was found in blood donors in some European countries. Transfusion-transmitted infections by contaminated blood products were reported in Japan and sporadically in Europe.

Materials and methods Several samples from a plasma donor were screened with a highly sensitive quantitative HEV RT-PCR and the full-length genome was generated. Serology was performed with two different commercially available ELISA kits.

Results The full-length genome sequence of human HEV was identified using samples from a plasma donor with acute self-limiting hepatitis. Plasma donated two weeks before onset of elevated liver enzyme levels was already positive for HEV RNA (10⁴ copies/mL). High viraemia (10⁶ copies/mL) correlated with the detection of anti-HEV IgM in the first blood sample with increased ALT levels. Phylogenetic analyses grouped the isolate within genotype 3, subtype 3f.

Conclusion The sequence analyses and the epidemiological data revealed that the plasma donor was most probably infected with a swine HEV. This case supports the ongoing discussion of an obligatory HEV NAT testing of blood products for special recipient risk groups.