Table 1.
Reported cases with transfusion transmitted hepatitis E virus infection.
| Year | Country | Age/ Sex |
Recipient (serology and PCR result) |
Blood donor (serology and PCR result) |
|||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary Diagnosis | Detection HEV after blood transfusion | HEV IgM | HEV IgG | HEV RNA PCR | Genotype identified | Component transfused | Outcome of the disease | HEV IgM | HEV IgG | HEV RNA PCR | Genotype identified | Sequence region | |||
| 2004 | Japan [7] | 67/M | Open Heart Surgery | 37 days | + | + | + | 4 | FFP | On day 130 of post-transfusion, the patient had no sign of Hepatitis | - | - | + | 4 | ORF1 |
| 2004 | Japan [16] | 31/M | Haemodialysis | 21 days | - | - | + | 3 | RBC | Sub-clinical infection without any raise in ALT enzyme | - | - | + | 3 | ORF2 |
| 2006 | UK [17] | 65/M | B Cell Lymphoma | 34 days | - | - | + | 3 | RBC | The patients remain asymptomatic with mild jaundice and anti-HEV IgG undetectable till day 132 of post-transfusion | + | + | + | 3 | ORF2 |
| 2007 | France [10] | 7/M | Rhabdoid Tumour in Kidney | NA | + | NA | + | 3f | RBC | NA | - | - | + | 3f | ORF2 |
| 2007 | Japan [18] | 21/M | T-Cell Lymphoma | NA | - | - | + | 3 | RBC | The patient died, and poor immune response | NA | NA | + | 3 | Whole gene |
| 2008 | Japan [19] | 64/M | Non-Hodgkin’s Lymphoma, ASCTP | 22 days | NA | NA | + | 4 | Platelet | Spontaneous resolution | + | + | + | 4 | ORF2 |
| 2012 | France [20] | 81/M | Chronic Autoimmune thrombocytopenia | Five months post blood transfusion (~164 days) | + | + | + | 3f | Platelet | The patient died | - | - | + | 3f | ORF1 & ORF2 |
| 2013 | France [21] | 55/M | Liver Transplant due to HCC (of HBV) | 17 days | - | - | + | 3c | RBC | Resolved with Ribavirin therapy | - | - | + | 3c | ORF1 & ORF2 |
| 2014 | France [11] | 36/M | Chronic renal failure, renal transplant | ~4 months | + | - | + | 3f | FFP | Chronic HEV infection, therefore, Ribavirin therapy was initiated | NA | NA | + | 3f | ORF1 |
| 2014 | France [11] | 61/M | Liver Transplant | ~6 months | - | - | + | 3f | FFP | The patient remained viremic even after two months. Therefore, Ribavirin treatment was given | NA | NA | + | 3f | ORF1 |
| 2014 | Japan [22] | 70/M | Myelodysplastic syndrome | 21 days | - | - | + | 3 | RBC | The patient died of a lung abscess | - | - | + | 3 | ORF2 |
| 2014 | Germany [23] | 47/M | Immunocompromised, Chronic HEV | 20 days | + | + | + | 3f | Platelet | Chronic HEV infection | - | - | + | 3f | ORF1 |
| 2015 | Japan [24] | 70s/M | Myocardial Infarction | 10 days | + | + | + | 3 | Platelet | Spontaneous resolution, HEV RNA undetectable at day 115 of post transfusion | NA | NA | + | 3 | ORF2 |
| 2016 | France [25] | 48/F | Kidney Transplant | 14 months | - | + | + | 3f | FFP | Chronic Hepatitis E virus infection | NA | NA | + | 3f | ORF1 |
| 2016 | Japan [26] | 41/M | Living donor liver transplant | 3 days | + | + | + | 3b | Platelet | Chronic HEV infection, HEV RNA becomes negative on day 417 of POD | NA | NA | + | 3b | ORF1 & ORF2 |
| 2016 | Japan [27] | 37/F | Burkitt’s Lymphoma | NA | - | - | + | 3 | Platelet | Chronic HEV infection, no viral RNA clearance even after eight months of ribavirin therapy | NA | NA | + | 3 | ORF1 & ORF2 |
| 2016 | Germany [28] | 33/M | Stem cell transplant | NA | NA | NA | + | 3 | RBC | Chronic HEV infection, there is a relapse of HEV after ribavirin treatment was stopped | NA | +NA | + | 3 | NA |
| 2016 | Germany [28] | 71/M | Heart Transplant | 54 days | NA | NA | + | 3 | Plasma | ALT normalized within three months; however, no antiviral treatment could be the reason that fluctuates the viral load without HEV RNA clearance | NA | NA | + | 3 | NA |
| 2016 | Germany [28] | 61/F | Acute Myeloid Leukaemia | 49 days | NA | + | NA | 3 | Platelet | NA | NA | NA | + | 3 | NA |
| 2017 | Spain [29] | 61/M | Axillofemoral bypass surgery | >1 month of transfusion | + | NA | + | 3f | RBC | Spontaneous resolution after one month of diagnosis | - | - | + | 3f | ORF2 |
| 2017 | France [13] | M | Splenectomy due to splenic injury | 35 days | - | - | + | 3f | Platelet | After two months of ribavirin treatment, the viral load decreased but continued till day 135 of post-trauma | NA | NA | + | 3f | ORF2 |
| 2017 | France [30] | 56/M | Heart Transplant | 68 days | + | + | + | 3 | RBC | The patient died of multi-organ failure on day 153 of POD | - | - | + | 3 | ORF2 |
| 2017 | Australia [31] | 6/M | Liver Transplant | More than two months after transfusion | NA | NA | + | 3 | FFP | Resolved after three months of ribavirin therapy | NA | NA | + | 3 | ORF2 |
| 2017 | France [32] | 34/F | Liver transplant | ~4 months | - | - | + | 3 | RBC | NA | - | - | + | 3 | ORF2 |
| 2017 | France [32] | 42/F | Liver transplant | ~4 months | - | - | + | 3f | ATP | NA | - | - | + | 3f | ORF2 |
| 2018 | Greece [33] | 50/M | Thalassaemia | 2 months | + | NA | + | 3 | RBC | Self-limiting, recovered within a month, all biochemical test normalized | + | NA | + | 3 | ORF2 |
| 2018 | Spain [34] | 48/M | Thrombocytopenic Purpura | 2 months | + | + | + | 3f | Cryo# | After 12 weeks of ribavirin treatment, the ALT, and platelet become normal, and HEV RNA is undetectable | + | - | + | 3f | ORF2 |
| 2019 | Japan [35] | 64/F | Acute Myeloid Leukaemia* | 112 days | - | - | + | 3b | Platelet | Progress to Chronic infections, HEV RNA and IgM undetectable at day 321 post transfusion | NA | NA | + | 3b | ORF2 |
| 2020 | France [36] | 50-59/M | Thrombotic Microangiopathy | 45 days | + | + | + | 3f | Plasma | NA | NA | NA | + | 3f | ORF1 & ORF2 |
| 2020 | France [36] | 50-59/M | Liver Transplant | 3 months post-transplant | + | - | + | 3f | Plasma | Chronic infection successfully treated with Ribavirin therapy | NA | NA | + | 3f | ORF1 & ORF2 |
| France [37] | 57/M | Thyrotoxicosis and drug-induced thrombotic microangiopathy | Within two months after transfusion | NA | NA | + | 3f | SD-plasma | No therapy, spontaneous resolution | NA | NA | + | 3f | ORF1 & ORF2 | |
| France [37] | 55/M | Kidney transplant | Within two months after transfusion | NA | NA | + | 3f | SD-plasma | Chronic Infection, ribavirin treatment resolved the infection after three months | NA | NA | + | 3f | ORF-2 | |
| France [37] | 58/M | Liver Cirrhosis and Transplantation | Within three months after transfusion | NA | NA | + | 3f | SD-plasma | Chronic infection, resolved after six months of ribavirin treatment | NA | NA | + | 3f | ORF-1 | |
| France [37] | 42/F | Acute Myeloid Leukaemia | Within a month after transfusion | NA | NA | + | 3f | WBPC | Chronic infection, resolved after seven months of ribavirin treatment | NA | NA | + | 3f | ORF-2 | |
| France [37] | 67/F | Non-Hodgkin Lymphoma | Within three months after transfusion | NA | NA | + | 3f | RBC | Chronic infection, resolved after a month and a half treatment with ribavirin | NA | NA | + | 3f | ORF-2 | |
| France [37] | 64/M | Allogenic Hematopoietic stem cell transplantation | After six months of transfusion | NA | NA | + | 3f | RBC | Chronic infection, spontaneous resolution | NA | NA | + | 3f | ORF-2 | |
| France [37] | 88/M | Chronic Lymphoid Leukaemia | Within a month after blood transfusion | NA | NA | + | 3c | RBC | Chronic infection, spontaneous resolution | NA | NA | + | 3f | ORF-1 | |
| France [37] | 36/M | Hemolytic Uremic Syndrome/Kidney Transplant | Within six months after transfusion | NA | NA | + | 3f | SD-plasma | Chronic infection, resolved after five months of ribavirin therapy | NA | NA | + | 3f | ORF-2 | |
| France [37] | 44/F | Chronic renal failure/Kidney Transplant | After six months of transfusion | NA | NA | + | 3f | RBC | Chronic infection, treatment associated resolution of three-month ribavirin therapy | NA | NA | + | 3f | ORF-1 | |
| France [37] | 50/M | Hodgkin Lymphoma/allogenic HSC transplantation | After six months of transfusion | NA | NA | + | 3c | APC | Chronic infection, spontaneous resolution at allogenic HSC transplantation, i.e. in the context of reduced immunosuppression | NA | NA | + | 3c | ORF-1 & ORF-2 | |
| France [37] | 55/F | Hodgkin Lymphoma/allogenic HSC transplantation | Within a month after transfusion | NA | NA | + | 4d | APC | Chronic infection, spontaneous resolution at allogenic HSC transplantation, i.e. in the context of reduced immunosuppression | NA | NA | + | 4d | ORF-1 | |
| France [37] | 46/F | Acute Myeloid Leukaemia | Within three months of transfusion | NA | NA | + | 3a | WBPC | Spontaneous resolution | NA | NA | + | 3a | ORF-2 | |
| France [37] | 60/M | Acute Myeloid Leukaemia/allogenic HSC transplantation | Within a month after transfusion | NA | NA | + | 3f | WBPC | Treatment-associated resolution after three months of ribavirin therapy | NA | NA | + | 3f | ORF-2 | |
| France [37] | 18/M | Acute Lymphoid Leukaemia | Within a month after transfusion | NA | NA | + | 3c | WBPC | Ribavirin treatment associated resolution | NA | NA | + | 3c | ORF-2 | |
| France [37] | 47/M | Bilateral Lung Infection | Within three months after transfusion | NA | NA | + | 3f | APC | Spontaneous resolution | NA | NA | + | 3f | ORF-2 | |
#cryosupernatant plasma, FFP; Fresh frozen Plasma, SD-plasma; Solvent or detergent treated plasma, RBC; Red blood concentrate, WBPC; Whole blood pooled platelet concentrate, APC; Apheresis platelet concentrate, ASCTP; autologous peripheral stem cell transplant, ALT; Alanine transaminase, NA; Not available, POD; post operative day.