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Abstract：
BACKGROUND: Hepatitis E virus (HEV) is usually transmitted by faecal-oral route. Recent reports have documented HEV viraemia in donated blood units and HEV transmission through blood transfusion. This systematic review summarizes the available data on prevalence of HEV viraemia in blood donors.
METHODS: Electronic databases were searched on 17 December 2018 to identify full-text English papers reporting original data on prevalence of HEV RNA in donated blood units. Two authors independently extracted the relevant data, which were pooled using simple aggregation as well as a random-effects meta-analysis; heterogeneity was assessed using the I2 method.
RESULTS: In all, 59 data sets from 28 countries were identified. The available data showed marked heterogeneity. Of a total of 2 127 832 units studied, 561 (263·6 [95% confidence intervals = 242·7-286·4] per million units) tested positive for HEV RNA. On random-effects meta-analysis, the pooled prevalence was 60·9 [6·7-155·4] per million units. In the viraemic units, HEV RNA titre varied by nearly one million-fold, and most had genotype 3 HEV. The prevalence was higher in blood units with anti-HEV antibodies or elevated alanine aminotransferase. Only nearly one-fourth of viraemic units had anti-HEV antibodies.
CONCLUSIONS: The prevalence of HEV viraemia among healthy blood donors is low, though the available data had limited geographical representation and marked heterogeneity. There is a need for further data on HEV viraemia in blood donors from areas with non-3 HEV genotype preponderance.
METHODS: Electronic databases were searched on 17 December 2018 to identify full-text English papers reporting original data on prevalence of HEV RNA in donated blood units. Two authors independently extracted the relevant data, which were pooled using simple aggregation as well as a random-effects meta-analysis; heterogeneity was assessed using the I2 method.
RESULTS: In all, 59 data sets from 28 countries were identified. The available data showed marked heterogeneity. Of a total of 2 127 832 units studied, 561 (263·6 [95% confidence intervals = 242·7-286·4] per million units) tested positive for HEV RNA. On random-effects meta-analysis, the pooled prevalence was 60·9 [6·7-155·4] per million units. In the viraemic units, HEV RNA titre varied by nearly one million-fold, and most had genotype 3 HEV. The prevalence was higher in blood units with anti-HEV antibodies or elevated alanine aminotransferase. Only nearly one-fourth of viraemic units had anti-HEV antibodies.
CONCLUSIONS: The prevalence of HEV viraemia among healthy blood donors is low, though the available data had limited geographical representation and marked heterogeneity. There is a need for further data on HEV viraemia in blood donors from areas with non-3 HEV genotype preponderance.
摘要：
背景：戊型肝炎病毒（HEV）通常通过粪便-口腔途径传播。最近的报告记录了捐赠血液单位中的HEV病毒血症和通过输血的HEV传播。本系统评价总结了献血者中HEV病毒血症患病率的现有数据。
方法：于2018年12月17日检索了电子数据库，以确定报告捐献血液单位中HEVRNA患病率原始数据的全文英文论文。两位作者独立提取了相关数据，使用简单聚合和随机效应荟萃分析进行汇总;使用I2方法评估异质性。
结果：总而言之，确定了来自28个国家的59个数据集。现有数据显示出明显的异质性。在研究的2.127.832台机组中,561（每百万单位263·6[95%置信区间=242·7-286·4]）的HEVRNA检测呈阳性。关于随机效应荟萃分析，合并患病率为每百万单位60·9[6·7-155·4].在病毒感染者中，HEVRNA滴度变化近一百万倍，大多数患有基因型3HEV。抗HEV抗体或丙氨酸转氨酶升高的血液单位的患病率较高。只有近四分之一的病毒血症单位具有抗HEV抗体。
结论：健康献血者中HEV病毒血症的患病率较低，尽管可用数据具有有限的地理代表性和明显的异质性。在非3型HEV基因型占优势的地区的献血者中，需要更多的HEV病毒血症数据。
方法：于2018年12月17日检索了电子数据库，以确定报告捐献血液单位中HEVRNA患病率原始数据的全文英文论文。两位作者独立提取了相关数据，使用简单聚合和随机效应荟萃分析进行汇总;使用I2方法评估异质性。
结果：总而言之，确定了来自28个国家的59个数据集。现有数据显示出明显的异质性。在研究的2.127.832台机组中,561（每百万单位263·6[95%置信区间=242·7-286·4]）的HEVRNA检测呈阳性。关于随机效应荟萃分析，合并患病率为每百万单位60·9[6·7-155·4].在病毒感染者中，HEVRNA滴度变化近一百万倍，大多数患有基因型3HEV。抗HEV抗体或丙氨酸转氨酶升高的血液单位的患病率较高。只有近四分之一的病毒血症单位具有抗HEV抗体。
结论：健康献血者中HEV病毒血症的患病率较低，尽管可用数据具有有限的地理代表性和明显的异质性。在非3型HEV基因型占优势的地区的献血者中，需要更多的HEV病毒血症数据。
