02221nas a2200277   4500008003900000245010200039210006900141260000800210490000700218520146100225100001401686700002001700700001301720700001301733700001301746700001401759700001601773700001701789700001601806700001501822700001501837700001401852700001201866700001601878856004901894       2017                          d00aUnique clinical courses of transfusion-transmitted hepatitis E in patients with immunosuppression0 aUnique clinical courses of transfusiontransmitted hepatitis E in  cFeb0 v573 aBACKGROUND:  The high prevalence of specific immunoglobulin G for hepatitis E virus (HEV) in Japanese people raises the possibility of a high incidence of HEV-viremic blood donors and therefore frequent transfusion-transmitted HEV (TT-HEV). STUDY DESIGN AND METHODS:  TT-HEV cases established in Japan through hemovigilance and those published in the literature were collected. Infectivity of HEV-contaminated blood components and disease severity in relation to immunosuppression were investigated. RESULTS:  Twenty established TT-HEV cases were recorded over the past 17 years. A lookback study verified that five of 10 patients transfused with known HEV-contaminated blood components acquired HEV infection. The minimal infectious dose of HEV through transfusion was 3.6 × 104 IU. Nine of the 19 TT-HEV cases analyzed had hematologic diseases. Only two cases showed the maximal alanine aminotransferase level of more than 1000 U/L. Two patients with hematologic malignancy and two liver transplant recipients had chronic liver injury of moderate severity. CONCLUSION:  The infectivity of HEV-contaminated components was 50%. Immunosuppression likely causes the moderate illness of TT-HEV, but it may lead to the establishment of chronic sequelae. Transfusion recipients, a population that is variably immunosuppressed, are more vulnerable to chronic liver injury as a result of TT-HEV than the general population is as a result of food-borne infection.1 aSatake, M1 aMatsubayashi, K1 aHoshi, Y1 aTaira, R1 aFurui, Y1 aKokudo, N1 aAkamatsu, N1 aYoshizumi, T1 aOhkohchi, N1 aOkamoto, H1 aMiyoshi, M1 aTamura, A1 aFuse, K1 aTadokoro, K  uhttps://www.notifylibrary.org/reference/4800