There is growing concern regarding the risk of transfusion- transmitted (TT) hepatitis E. Since the first described case in 2006, several TT hepatitis E have been reported to the French hemovigilance network. We performed a retrospective analysis of all cases of TT hepatitis E reported between 2006 and 2016. Transfusion-transmitted hepatitis E with high imputability according to phylogenetic analysis occurred in 23 patients aged 8 to 88 years and involved mostly solid organ recipients (n = 9) or patients with malignant hematological diseases (n = 9, including 4 hematopoietic allograft recipients). Involved blood products were plasma (n = 7), among which 6 had undergone pathogen reduction with solvent/detergent (n = 4) or amotosalen + ultra-violet A (UVA) (n = 2 from 1 donation) treatments, red blood concentrates (n = 7), apheresis platelets concentrates (n = 3) and whole blood pooled platelets concentrates (n = 6), among which one had underwent amotosalen + UVA treatment. Median hepatitis E virus (HEV) RNA dose infused was 5.79 [4.36–10.10] log IU. HEV infection progressed to chronic hepatitis E in 14 (61%) immunocompromised patients, 2 of whom had advanced liver fibrosis at diagnosis. Chronic hepatitis E patients cleared HEV with ribavirin treatment (n = 10), after immunosuppressive drug reduction (n = 3), or spontaneously (n = 1). One additional organ transplant recipient with associated co-morbidities died with ongoing HEV infection and multiple organ failure. The other 8 (34.8%) patients with TT hepatitis E cleared HEV within 6 months with ribavirin treatment (n = 3), reduced immunosuppression (n = 1) or spontaneously (n = 4). Red cells, platelets, and plasma transfusions may be associated with TT hepatitis E that can evolve to chronic hepatitis E in immunocompromised patients. Hepatitis E virus has emerged in France as a clinically significant TT infection risk.

人们越来越关注输血传播（TT）戊型肝炎的风险。自2006年首次描述该病例以来，法国血液警戒网络已报告了数种TT型戊型肝炎。我们对2006年至2016年间报告的所有TT型戊型肝炎病例进行了回顾性分析。根据系统发育分析，输血传播的戊型肝炎高易感性发生在23例8至88岁的患者中，主要涉及实体器官接受者（n = 9）或恶性血液病患者（n = 9，包括4名造血同种异体移植受者）。涉及的血液制品为血浆（n = 7），其中6种已通过溶剂/洗涤剂（n = 4）或Amotosalen +紫外线A（UVA）（n = 1捐献2次）治疗，红血球浓缩剂减少了病原体（n = 7），单采血液浓缩血小板浓缩液（n = 3）和全血浓缩血小板浓缩液（n = 6），其中一个接受过阿托莫仑+ UVA处理。输注的戊型肝炎病毒（HEV）中位RNA剂量为5.79 [4.36-10.10] log IU。14例免疫功能低下的患者中，戊型肝炎病毒感染进展为慢性戊型肝炎，其中2例在诊断时患有晚期肝纤维化。慢性戊型肝炎患者在接受免疫抑制药物减少后（n = 3）或自发（n = 1）通过利巴韦林治疗（n = 10）清除了戊型肝炎病毒。另外一名伴有合并症的器官移植患者死于正在进行的HEV感染和多器官功能衰竭。其余8名（34.8％）戊型肝炎TT患者在接受病毒唑治疗（n = 3），免疫抑制降低（n = 1）或自发（n = 4）的6个月内清除了HEV。红细胞，血小板，血浆输血可能与TT型戊型肝炎有关，在免疫力低下的患者中可能演变为慢性戊型肝炎。在法国，戊型肝炎病毒已成为临床上重要的TT感染风险。