J Hepatol:HEV阳性捐献者的血液制品对免疫缺陷患者来说,具有相关的感染风险

2018-07-25 MedSci MedSci原创

在德国北部的献血者中,可以以相对较高的速度检测到长时间的HEV病毒血症,HEV病毒血症能够导致一些有严重和致命并发症风险的患者中发生输血传播的HEV感染。

研究背景:最近,英国和荷兰已建立对血液制品进行常规HEV检测的方案。然而,输血传播戊型肝炎病毒感染的相关性在欧洲仍有争议。

研究方法:2016年10月至2017年5月,Hamburg-Eppendorf的所有血液捐献品都采用PCR对HEV RNA进行检测。反应样品分别重新测试。此外,还对先前捐赠的阳性献血者的储存样本进行了检测,以确定HEV病毒血症的持续时间。HEV RNA阳性供者和对照组被要求回答一份问卷。

研究结果:在18737例戊肝病毒RNA阳性捐助者中,其中23例患者存在病毒血症。只有2例阳性供者(8.7%)在捐献时出现了较高的氨基转移酶(丙氨酸氨基转移酶:192和101U/L)。对所有阳性供者的回顾性分析显示,4例无症状供者HEV病毒血症期最多为3个月,最长持续时间为超过4个月。尽管进行了HEV测试,14个HEV RNA阳性的血液制品被输入到12例免疫缺陷患者和2例免疫能力正常的患者中。这些血液制品的一个接受者发生了致命的急性慢性肝功能衰竭合并假单胞菌血症。问卷显示,对比对照组,HEV RNA阳性供者更常食用生肉(18人中有12人;67% VS 256中89例; 35%; p = 0.01)。在两个供者中,未煮熟的猪肝被确认为感染源。23例HEV病毒供者中有7例可能进行HEV基因分型,7例分离株中有6珠分离株属于HEV基因型3,组2。

研究结论:在德国北部的献血者中,可以以相对较高的速度检测到长时间的HEV病毒血症,HEV病毒血症能够导致一些有严重和致命并发症风险的患者中发生输血传播的HEV感染。

原始出处:

Westholter D, Hiller J, Denzer U, et al. HEV-positive blood donations represent a relevant infection risk for immunosuppressed recipients. J Hepatol, 2018, 69(1), 36-42.

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    2018-07-27 gwc384
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    2018-07-27 yzh404
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    2018-07-27 yzh404
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