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. 2023 Sep 22;11(10):2375.
doi: 10.3390/microorganisms11102375.

Epidemiology of HEV Infection in Blood Donors in Southern Switzerland

Stefano Fontana  1   2 , Paolo Ripellino  3   4 , Christoph Niederhauser  5   6 , Nadja Widmer  5 , Peter Gowland  5 , Orlando Petrini  7 , Manuela Aprile  1 , Giorgio Merlani  8 , Florian Bihl  9   10
Affiliations

Epidemiology of HEV Infection in Blood Donors in Southern Switzerland

Stefano Fontana et al. Microorganisms. .

Abstract

From 2014 to 2016, the number of hepatitis E virus (HEV) infections in southern Switzerland increased dramatically and suggested food as a potential infection reservoir. We evaluated the effects of food control measures introduced to limit HEV infections, assessing anti-HEV IgG and IgM rates in blood donors before and after the implementation of food control measures in 2017. From 2012 to 2013, we screened 1283, and from 2017 to 2019, we screened 1447 donors for IgG and IgM antibodies. No statistically significant differences were detected for IgG (32.8% from 2012 to 2013 vs. 31.1% from 2017 to 2019, p = 0.337) or IgM rates (2.0% from 2012 to 2013 vs. 2.8% from 2017 to 2019, p = 0.21). Rural provenience and age > 66 are predictors for positive IgG serology. A total of 5.9% of 303 donors included in both groups lost IgG positivity. We also determined nucleic acid testing (NAT) rates after the introduction of this test in 2018, comparing 49,345 donation results from southern Switzerland with those of 625,559 Swiss donor controls, and only 9 NAT-positive donors were found from 2018 to 2023. The high HEV seroprevalence in southern Switzerland may depend on different food supply chains in rural and urban areas. Local preventive measures probably have a limited impact on blood HEV risk; thus, continuous NAT testing is recommended.

Keywords: NAT testing; blood donors; hepatitis E; seroprevalence; transfusion safety.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Regional and district distribution of the HEV IgG (navy color) and IgM (red, in parentheses) seroprevalence in blood donors, 2017–2019. BE, Bellinzona; BL, Blenio; GI, Grigioni Italiano; LE, Leventina; LO, Locarno; LU, Lugano; ME, Mendrisio; RI, Riviera; VM, Vallemaggia. Green fill: south; blue fill: center; yellow fill: north; Grigioni Italiano: light yellow.
Figure 2
Figure 2
Distribution of the HEV IgG and IgM seroprevalence in blood donors according to their age in the two sampling periods 2012–2013 and 2017–2019.
Figure 3
Figure 3
Predicted changes of anti-HEV IgG in relationship to age (marginsplot). Outcome of the logistic regression using gender, age, sampling period, and areas as independent variables.
Figure 4
Figure 4
Odds ratios (point estimates: dots) and their 95% confidence intervals (lines) of a positive test in the southern Switzerland sample as compared to the Swiss control.
See this image and copyright information in PMC

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