Kinetics of Hepatitis E Virus Infections in Asymptomatic Persons

• Published in: Emerging infectious diseases Vol. 30; no. 5; pp. 934 - 940
• Main Authors: Plümers, Ricarda, Dreier, Jens, Knabbe, Cornelius, Steinmann, Eike, Todt, Daniel, Vollmer, Tanja
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01.05.2024; Centers for Disease Control and Prevention
• Subjects: Adult; Asymptomatic; Asymptomatic Infections - epidemiology; Blood & organ donations; Blood Donors; Blood products; Carrier state (Communicable diseases); Development and progression; doubling time; Female; Germany - epidemiology; Health aspects; Hepatitis; Hepatitis Antibodies - blood; Hepatitis E; Hepatitis E - epidemiology; Hepatitis E - virology; Hepatitis E virus; Hepatitis E virus - genetics; Hepatitis E virus - immunology; Humans; immune response; Immunoglobulin G; Immunoglobulin G - blood; Immunoglobulin M - blood; Infection; Infections; Kinetics; Kinetics of Hepatitis E Virus Infections in Asymptomatic Persons; Male; Measurement; Middle Aged; Retrospective Studies; Risk assessment; Risk factors; RNA; RNA, Viral; Software; Viral infections; Viral Load; Viremia; Virus research; Viruses; Young Adult; Germany; viruses; doubling time; immune response; asymptomatic; blood safety; transfusion; hepatitis; Germany; Hepatitis E virus
• ISSN: 1080-6040; 1080-6059
• DOI: 10.3201/eid3005.231764

To determine the kinetics of hepatitis E virus (HEV) in asymptomatic persons and to evaluate viral load doubling time and half-life, we retrospectively tested samples retained from 32 HEV RNA-positive asymptomatic blood donors in Germany. Close-meshed monitoring of viral load and seroconversion in intervals of ≈4 days provided more information about the kinetics of asymptomatic HEV infections. We determined that a typical median infection began with PCR-detectable viremia at 36 days and a maximum viral load of 2.0 × 10 IU/mL. Viremia doubled in 2.4 days and had a half-life of 1.6 days. HEV IgM started to rise on about day 33 and peaked on day 36; IgG started to rise on about day 32 and peaked on day 53. Although HEV IgG titers remained stable, IgM titers became undetectable in 40% of donors. Knowledge of the dynamics of HEV viremia is useful for assessing the risk for transfusion-transmitted hepatitis E.