Transfusion-transmitted hepatitis E: What we know so far?

Table 3 Seroprevalence of hepatitis E in blood donors

Ref.	Country	Number of donations screened	Assay used	Number of samples positive for HEV IgG antibodies	Anti-HEV IgG prevalence (95%CI)	Number of samples positive for HEV IgM antibodies	Anti-HEV IgM prevalence (95%CI)	Number of samples positive for HEV RNA in anti-HEV IgM positive	Viral load, IU/mL	Genotype
Europe
Fischer et al[45], 2015	Austria	1203 (from HEV RNA negative donors)	Wantai	163	13.55% (11.6%-15.5%)	N/A	N/A	0	N/A	N/A
Vercouter et al[46], 2019	Belgium	356 (from HEV RNA negative donors)	Wantai	31	8.71% (6.20%-12.10%)	0	N/A	0	N/A	N/A
Miletić et al[87], 2019	Croatia	1036	3 commercial ELISA assays were used, only findings with highest prevalence are shown	209	20.17%	46	4.44%	0	N/A	N/A
Holm et al[88], 2015	Denmark	504	In-house NIH assay	54	10.7% (8.2%-13.7%)	N/A	N/A	N/A	N/A	N/A
			Wantai	100	19.8% (16.4%-23.6%)
Dimeglio et al[89], 2018	France	300	Wantai	23	7.7% (4.9%-11.3%)	2	0.6% (0.1%-2.4%)	0	N/A	N/A
Juhl et al[90], 2013	Germany	1019	RecomWell assay and Western blot	69	6.8% (5.3%-8.3%)	N/A	N/A	N/A	N/A	N/A
Dalekos et al[91], 1998	Greece	3016	Abbott assay and Western blot	8	0.27%	0	N/A	N/A	N/A	N/A
O'Riordan et al[54], 2016	Ireland	1076	Wantai	57	5.3% (4.0%-6.8%)	2	0.19%	0	N/A	N/A
Spreafico et al[55], 2020	Italy	767	DiaPro	52	6.8% (5.1%-8.8%)	0	N/A	0	N/A	N/A
Spada et al[56], 2018	Italy	10011	Wantai	869	8.7% (8.14%-9.25%)	46	0.4% (0.34% - 0.61%)	0	N/A	N/A
De Sabato et al[92], 2017	Italy	170	Bio-Chain Institute and Western blot	15	8.82%	3	1.76%	0	N/A	N/A
Lucarelli et al[93], 2016	Italy	313	Wantai	153	48.9% (43%-54%)	2	0.6% (0.08%-2.3%)	1	100	3
Puttini et al[94], 2015	Italy	132	EIAgen HEV IgG kit	12	9.1%	N/A	N/A	N/A	N/A	N/A
Hogema et al[95], 2014	Netherlands	513	Wantai	58	11.31%	N/A	N/A	N/A	N/A	N/A
Slot et al[58], 2013	Netherlands	5239	Wantai	1401	26.7% (25.6%-28.0%)	49	0.94%	4	Range: < 25 to 3700	3
Grabarczyk et al[59], 2018	Poland	3079	Wantai	1340	43.52% (41.78%-45.28%)	39	1.27% (0.93%-1.73%)	N/A	N/A	N/A
Sauleda et al[61], 2015	Spain	1082	Wantai	216	19.96% (17.60%-22.32%)	13	1.20%	0	N/A	N/A
			Mikrogen	116	10.72% (8.90%-12.60%)
Mateos et al[96], 1999	Spain	863	Abbott assay and Western blot	34	3.9%	0	N/A	N/A	N/A	N/A
Niederhauser et al[97], 2018	Switzerland	3609	Wantai	737	20.4% (19.1%-21.8%)	N/A	N/A	N/A	N/A	N/A
Kaufmann et al[98], 2011	Switzerland	550	MP Biomedicals	27	4.9%	N/A	N/A	N/A	N/A	N/A
Thom et al[63], 2018	United Kingdom	1714	Wantai	104	6.1% (5.0%-7.3%)	N/A	N/A	N/A	N/A	N/A
Cleland et al[65], 2013	United Kingdom	1559	Wantai	73	4.7% (3.6%-5.8%)	0	N/A	N/A	N/A	N/A
Beale et al[99], 2011	United Kingdom	262	Wantai	31	11.8%	4	1.5%	0	N/A	N/A
North America
Zafrullah et al[100], 2018	United States	5040 (from HEV RNA negative donor)	DSI	569	11.29%	146	2.90%	0	N/A	N/A
			MP Biomedicals	537	10.65%	93	1.85%
			Wantai	619	12.28%	34	0.67%
Stramer et al[68], 2016	United States	4499	MP Biomedicals	329	7.3% (6.6%-8.1%)	26	0.58% (0.39%-0.85%)	N/A	N/A	N/A
Xu et al[69], 2013	United States	1939	Wantai	364	18.8% (17.0%-20.5%)	8	0.4% (0.1%-0.7%)	0	N/A	N/A
South America
Di Lello et al[101], 2020	Argentina	391	DiaPro	44	11.3%	8	2.0%	0	N/A	N/A
Bangueses et al[102], 2020	Uruguay	400	DiaPro	40	10%	19	4.75%	3	N/A	3
Asia
Nouhin et al[103], 2016	Cambodia	301	Wantai	85	28.2% (23.4%-33.5%)	3	1.0% (0.01%-1.8%)	1	956	3
Chen et al[104], 2019	China	4044	Wantai	799	19.8% (18.6%-21.0%)	43	1.1% (0.8%-1.4%)	2	N/A	4
Wen et al[70], 2018	China	5345	Wantai	1227	22.96%	38	0.71%	15	N/A	N/A
Wang et al[105], 2017	China	9069	Wantai	2682	29.57%	131	1.44%	5	N/A	N/A
Ma et al[106], 2015	China	816	Wantai	172	21.1%	4	0.5%	0	N/A	N/A
Ren et al[107], 2014	China	10741	Wantai	2945	27.42%	109	1.01%	0	N/A	N/A
Zhuang et al[108], 2014	China	486	ELISA based on antigen protein pB166 and MPII	113	23.3%	N/A	N/A	N/A	N/A	N/A
Tsoi et al[71], 2019	Hong Kong	2000	Wantai	315	15.8% (14.2%-17.4%)	16	0.8%	0	N/A	N/A
Tripathy et al[109], 2019	India	2447	Wantai	433	17.70% (16.23%-19.26%)	5	0.20%	2	Ranged from 3.5 × 104 to 4.6 × 105 copies/mL	1
Katiyar et al[72], 2018	India	633	Wantai	383	60.5%	N/A	N/A	0	N/A	N/A
Gajjar et al[110], 2014	India	460	DiaPro	N/A	N/A	22	4.78%	N/A	N/A	N/A
Parsa et al[111], 2016	Iran	700	DiaPro	42	6.0%	5	0.71%	5 (only 50 seropositive blood donors were tested)	N/A	1
Hesamizadeh et al[112], 2016	Iran	559	DiaPro	45	8.05%	N/A	N/A	N/A	N/A	N/A
Naeimi et al[113], 2015	Iran	628	HEV IgG, Pasto, Iran	105	16.72%	N/A	N/A	N/A	N/A	N/A
Ehteram et al[114], 2013	Iran	530	DiaPro	76	14.3%	N/A	N/A	N/A	N/A	N/A
Taremi et al[115], 2007	Iran	399	DiaPro	31	7.8%	N/A	N/A	N/A	N/A	N/A
Takeda et al[116], 2010	Japan	12600	in-house ELISA	431	3.42%	N/A	N/A	N/A	N/A	N/A
Shrestha et al[117], 2016	Nepal	1845	Wantai	773	41.9% (39.7%-44.2%)	55	3.0% (2.2%-3.8%)	N/A	N/A	N/A
Nasrallah et al[118], 2017	Qatar	5854	Wantai	1198	20.46%	34	0.58%	4	N/A	N/A
Jupattanasin et al[119], 2019	Thailand	630	EUROIMMUN test kit	187	29.7% (26.2%-33.4%)	N/A	N/A	N/A	N/A	N/A
Africa
Traoré et al[120], 2016	Burkina Faso	1497	DiaPro and Wantai	584	39%	13	0.87%	N/A	N/A	N/A
Ibrahim et al[121], 2011	Egypt	760	N/A	N/A	N/A	3	0.39%	2	N/A	N/A
Meldal et al[122], 2013	Ghana	239	4 commercial assays were used, findings reactive in; at least two serological assays are shown	11	4.6%	14	5.9%	0	N/A	N/A
Lopes et al[123], 2017	South Africa	300	Fortress Diagnostics	76	25.3%	0	N/A	N/A	N/A	N/A
Ben-Ayed et al[124], 2015	Tunisia	426	Globe; Diagnostics Srl ELISA	19	4.46%	N/A	N/A	N/A	N/A	N/A
Others
Hewitt et al[77], 2018	New Zealand	1013	Wantai	98	9.7% (7.9%-11.7%)	N/A	N/A	N/A	N/A	N/A
			MP Biomedicals	82	8.1% (6.5%-10.0%)

ALT: Alanine aminotransferase; CI: Confidence interval; DSI: Diagnostic Systems Incorporated; ELISA: Enzyme-linked immunosorbent assay; HEV: Hepatitis E virus; NIH: National Institutes of Health.