SCREENING FOR HEPATITIS E VIRUS IN BLOOD DONORS IN NORTH MACEDONIA
Keywords:
Hepatitis E virus, Blood Donors, Transfusion-transmissible infections, NAT, Blood SafetyAbstract
Introduction: Hepatitis E virus (HEV) is an emerging transfusion-transmissible pathogen and a growing concern for blood safety. Since 2023, all blood donations in North Macedonia have been screened for HEV RNA, providing the first national prevalence data.
Material and methods: All blood donations collected in 2023 and 2024 were screened for HEV RNA using the Procleix UltrioPlex E nucleic acid test (NAT) on the Panther platform. Initially reactive (IR) samples were retested in duplicate, and repeatedly reactive (RR) samples underwent serological testing for anti-HEV IgM and IgG. Blood units were discarded upon the first positive NAT result. RR donors were recalled for follow-up testing after 4–6 months to assess viral clearance.
Results: A total of 107,950 donations from 71,306 donors were screened over two years. HEV RNA was initially detected in 130 samples (0.12%), with 75 confirmed as RR, yielding an overall prevalence of 0.069%. Prevalence was higher in 2024, reflecting a 64% increase. Follow-up showed viral clearance in 91.9% within 4–6 months, with all donors RNA-negative by the third follow-up. HEV positivity was not significantly associated with age or gender, though men had higher prevalence in 2023 (p = 0.031). Repeat donors in 2024 were more often positive than first-time donors (p = 0.042). Geographic clustering occurred in Skopje and Kavadarci, with seasonal peaks in March.
Conclusion: The detection of HEV among blood donors in North Macedonia highlights its relevance as a transfusion-transmissible infection and underscores the need for sustained surveillance and consideration of screening strategies.
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