Κατεύθυνση Θρόμβωση-Αιμορραγία-Ιατρική των μεταγγίσεων
Library of the School of Health Sciences

2020-07-24

2020

Manoli Eirini

Γιαλεράκη Αργυρή Επίκουρη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Σταμούλης Κωνσταντίνος, Επιστημονικός Διευθυντής, Εθνικό Κέντρο Αιμοδοσίας
Βαλσάμη Σερένα Επίκουρη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ

Ηπατίτιδα Ε και μεταγγίσεις ανασκόπηση

Greek

Hepatitis and trasfusions review

The increasingly native cases of hepatitis E in the European continent with high rates of seroprevalence and proven viremia as well as high prevalence in animal populations classify HEV as an appreciable risk to public health. Particularly at the level of transfusion therapy, the recording of transmission cases of the virus through blood transfusion (TT-HEV) raise concern on the safety of the transfused blood.
8 genotypes have been identified, of which 1,2 genotypes are only present in humans, are found in developing countries and cause food-borne and aquatic pests, while genotypes 3,4 are found in the developed countries, detected in animals and transmitted to humans through ingestion by eating raw or rare cooked meat. Pigs are the main repository of genotype 3. Each genotype is considered to be dominant in a certain geographical area and the infection caused is called indigenous for this particular area but is not limited to it.
Clinically, the infection is often caused from asymptomatic to self-limiting acute hepatitis with a disease duration of 6-7 weeks. Asymptomatic patients experience jaundice, abdominal pain, fever, arthralgia, and mortality may reach up to 10% with higher rates in children and pregnant women. Chronic infection has been recorded from genotype 3, primarily in immunosuppressed and transplanted patients in whom the rate reaches up to 50% with rapid progress towards hepatic cirrhosis.
The diagnosis of HEV requires a combination of molecular and serological techniques for detecting the infection and monitoring treatment efficacy in chronic patients. Serological diagnosis with the detection of IgM IgG antibodies by immunochromatography techniques and enzyme immunoassays is the most common method. It is noted that commercially available methods exhibit significant differences in sensitivity and specificity, thus limiting the ability to compare data with different immunoassays. Molecular control is useful in immunosuppressed patients who are unable to produce antibodies.
Given the presence of the virus in developing and developed countries, WHO has provided guidelines to address these situations as quickly and effectively as possible.
There are no recommendations for antiviral therapy in patients infected with HEV. The combination of pegylated interferon A with ribavirin shows an effective action against HEV.
The virus preference towards adults, the subclinical course of the disease and the mean duration of viremia in asymptomatic blood donors reaching 68 days increase the likelihood of choosing an infected donor.
Different national policies apply to the European countries with regard to the prevention of infection through blood transfusion (screening, NAT control, CLINICAL UPDATES).

Health Sciences

Hepatitis E , Trasfusions, Europe

No

0

Yes

103

100

File access is restricted only to the intranet of UoA.

https://pergamos.lib.uoa.gr/uoa/dl/object/2920218