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Adverse Occurrence type:
First report producing indirect evidence of HEV transmission by pooled plasma.
Time to detection:
Alerting signals, symptoms, evidence of occurrence:
Thirty-six TTP patients from Canadian apheresis centres who had received large volumes of either solvent detergent-treated plasma (SDP) prepared by pooling of 2500 single-donor or cryosupernatant plasma had samples collected at 0, 1 and 6 months post-treatment and were tested for anti-HEV antibodies. Patients with demonstrable HEV seroconversion (strong serological response detected at 6 months) were also tested for HEV RNA by PCR. Two of seventeen TTP patients treated with SDP showed HEV seroconversion, with detectable HEV RNA at 1 month; they remained asymptomatic. None of the 19 patients treated with cryosupernatant plasma showed serological evidence of HEV infection.
Demonstration of imputability or root cause:
The two patients who seroconverted following treatment had received the same lot of SDP; the product was not available for testing. The other SDP recipients who did not seroconvert had been treated with different lots of SDP. The authors do not give information on molecular analysis of the strains from the two infected recipients. As a non-enveloped virus, HEV is known to be resistant to solvent/detergent treatment.
Suggest new keywords:
- Andonov A, et al. Serological and molecular evidence of a plausible transmission of hepatitis E virus through pooled plasma. Vox sanguinis. 2014. - Hewitt, P et al. Hepatitis E virus in blood components: a prevalence and transmission study in southeast England. Lancet, 2014, Volume 384, Issue 9956, England, p.1766 - 73, (2014)