Study on the Infection Status of Hepatitis E Virus among Unpaid Blood Donors in Qinzhou Region and the Screening Strategy

Objective: To investigate the infection status of Hepatitis E virus (HEV) among unpaid blood donors in Qinzhou region, and to provide a basis for the formulation of blood screening strategies in China. Methods: From May to October 2023, blood samples of 13,015 unpaid blood donors were randomly collected from Qinzhou Central Blood Station. Enzyme-linked immunosorbent assay (ELISA) was used to detect hepatitis E virus antigen (HEV-Ag), antibodies (HEV-IgG, HEV-IgM). Single-person nucleic acid testing for HEV RNA was performed on samples positive for HEV-Ag and/or HEV-IgM using real-time PCR technology. Meanwhile, the level of alanine aminotransferase (ALT) was determined by enzymatic detection technology (rate method), and the chi-square test was used to analyze the differences in the positive rates of HEV-Ag, HEV-IgG, and HEV-IgM among different age groups, genders, ethnic groups, occupations, and ALT level groups. Results: Among the 13,015 unpaid blood donors, the positive rates of HEV-IgG, HEV-IgM, and HEV-Ag were 11.59% (1509/13,015), 0.73% (95/13,015), and 0.054% (7/13,015), respectively. The HEV RNA tests of 95 HEV-IgM positive samples and 7 HEV-Ag positive samples were all negative. There were statistically significant differences in the positive rates of HEV-IgG among different genders, ages, ethnic groups, and occupations (P < 0.05), while the difference in the positive rate of HEV-IgM was only statistically significant among different age groups (P < 0.05). The positive rates of anti-HEV IgG and HEV-IgM increased with the increase of the age of unpaid blood donors, rising from 3.47% and 0.37% in the age group of 18 to 25 years old to 26.91% and 1.36% in the age group of 46 years old and above, respectively. Conclusion: There is a certain prevalence of hepatitis E virus infection among unpaid blood donors in Qinzhou region. The level of past infection (IgG) is relatively high, while the current infection rate (HEV-IgM) is at a low level. There are differences in the HEV infection status among different populations. Therefore, it is necessary to formulate appropriate recruitment and screening strategies in combination with the HEV infection status of specific populations in Qinzhou region to reduce the risk of HEV transmission through blood transfusion.