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About 1 in 3000 donors in England have hepatitis E virus (HEV) in their plasma, an analysis of HEV by blood components has indicated.

According to the findings, around 1200 HEV-containing blood components are likely to be transfused every year in England.

The study considered around 225,000 individual blood donations and found that 79 donors were currently infected with genotype 3 HEV indicating a prevalence of about 1 in 2848.

"HEV genotype 3 infections are widespread in the English population, including blood donors. We estimate that between 80 000 and 100 000 human HEV infections are likely to have occurred in England during the year of our study", principal investigator Professor Richard Tedder from the Blood Borne Virus Unit at Public Health England, explained in the press release.

"Although rarely causing any acute illness, hepatitis E infections may become persistent in immunosuppressed patients, putting them at risk of future chronic liver disease, and a policy is needed to identify these persistently infected patients and provide them with appropriate antiviral treatment. However, our study indicates that the overall burden of harm resulting from transfusion-transmitted HEV is slight. Although on a clinical basis alone there appears no pressing need at this time for blood donations to be screened, a broader discussion over harm mitigation is now required."

Experts have called for the systematic screening of blood components for hepatitis E infection to be introduced in areas where HEV is endemic.

"Despite…[the] high prevalence, the high rate of transmission by infected blood or blood products, the non-negligible morbidity and mortality related to HEV infection (especially in patient populations exposed to blood or blood product transfusion), and the lack of efficient antiviral therapy, Hewitt and colleagues surprisingly conclude that "there seems no pressing need to move rapidly with the introduction of donation screening," wrote Professor Jean-Michel Pawlotsky from Hôpital Henri Mondor, Université Paris-Est, Créteil, France, in the linked comment.

The findings have been published in the journal The Lancet.