Acute, Recent and Past HEV Infection among Voluntary Blood Donors in China: A Systematic Review and Meta-Analysis

INTRODUCTION: Hepatitis E virus is one of new threats to blood safety which was usually considered to be transmitted via fecal-oral route. China is one of the hyperendemic regions where frequent outbreaks of hepatitis E are noted. However, the overall prevalence of HEV infection among mainland Chinese blood donors is not clear until now. METHOD: The peer-reviewed literatures reporting the prevalence of HEV in Chinese blood donors were identified by systematic searching of five electronic databases. The systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement issued in 2009. Data manipulation and statistical analyses were performed by Stata 12.0. RESULTS: Fourteen eligible articles involving 22 independent studies were included. Pooled prevalence of HEV infection biomarkers (anti-HEV IgG, anti-HEV IgM, RNA and antigen) among mainland Chinese blood donors were 29.2%, 1.1%, 0.1% and 0.1%, respectively which were higher than the data reported in other countries. The analysis of HEV genotypes indicated that the most prevalent strains in Chinese blood donors were genotype 1 and 4. CONCLUSIONS: Mainland China is indicated with a relatively higher risk of transmission of hepatitis E through transfusion and the screening of blood donors for HEV RNA, especially in HEV-endemic areas, might reduce the potential risk of HEV infection via transfusion.