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Red blood cell transfusion‐transmitted acute hepatitis E in an immunocompetent subject in Europe: a case report
Author(s) -
RiveiroBarciela Mar,
Sauleda Silvia,
Quer Josep,
Salvador Fernando,
Gregori Josep,
Pirón María,
RodríguezFrías Francisco,
Buti Maria
Publication year - 2017
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.13876
Subject(s) - blood transfusion , medicine , red blood cell , red blood cell transfusion , hepatitis , acute hepatitis , virology , intensive care medicine , immunology
BACKGROUND Acute hepatitis E in industrialized countries is usually related to intake or manipulation of undercooked or raw meat. Cases of transfusion‐transmitted hepatitis E have rarely been documented in immunosuppressed patients, mainly after receiving frozen plasma. STUDY DESIGN AND METHODS A 61‐year‐old man was admitted to hospital for jaundice. His personal history included disseminated bacillus Calmette‐Guerin infection treated with antituberculous drugs. He had received red blood cell (RBC) transfusion 2 months previously, during admission for mycotic aneurysm surgery. Since liver function tests worsened despite stopping antituberculous drugs, other causes of acute hepatitis were explored. RESULTS Acute hepatitis E was diagnosed by the presence of both immunoglobulin M and hepatitis E virus (HEV) RNA. Traceback procedure for the 8 RBC units was carried out, and one of the eight archive plasma samples tested positive for HEV RNA, with an estimated viral load of 75,000 IU/mL. Phylogenetic analysis revealed the same HEV strain Genotype 3 in one of the transfused RBC products and in the patient's serum sample. CONCLUSION Transfusion of RBCs with detectable HEV RNA is a risk factor for acute hepatitis E in immunocompetent patients in Europe.