Seroprevalence of Hepatitis E Virus among Healthy Blood Donors in Nairobi City County, Kenya
Fardolo, Ezekiel K.
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Hepatitis E disease is caused by Hepatitis E virus (HEV). The virus is an enteric virus that is transmitted via fecal contaminated food, water, blood transfusion, and organ transplants. HEV causes approximately twenty million infections globally, of which over three million are asymptomatic. In 2015, The World Heal Organization (WHO) reported that this virus accounted for approximately 55,000 deaths representing a 3.3% mortality rate. HEV is classified into at least four human infecting genotypes. Out of these known genotypes, genotypes one and two are endemic in Asia and Africa, while genotypes three and four are sporadically described in developed countries. Two previous studies in Kenya have reported a seroprevalence of 25.7% and 77 % among acute febrile illness and jaundice patients. Despite these reports, most African countries, including Kenya, do not screen for the virus during blood donation. Besides, the seroprevalence, and the molecular characteristics of this virus in blood donors in Nairobi, Kenya, remain unknown. Therefore, this study aimed to determine the seroprevalence of Hepatitis E virus circulating genotypes and the relationship between socio-demographic risk factors and the HEV on voluntary blood donors in Nairobi using a retrospective study design. Archived plasma samples from 358 voluntary blood donors were used. The obtained blood plasmas were screened for Hepatitis E virus IgM and IgG antibodies using a qualitative membrane-based immunoassay (Biopanda reagents, Belfast, UK). The collected blood donors' socio-demographic characteristics were analyzed using Chi-square in SPSS software version 20 to determine the relationship between the blood donor's socio-demographics and HEV infection. The total virus RNA from the seropositive samples was extracted using the ThermoFisher PureLinkTM Viral RNA/DNA Mini kit and used as a template to synthesize cDNA. A nested PCR was performed to amplify the HEV ORF2 gene. The blood donors recruited in this study were between 16-60 years and had a mean age of 29±14 years. Out of the 358 subjects, 36% (n = 130) were females, while 64% were male. In addition, 10.6% of the tested samples were HEV IgG seropositive, while 7.8% were HEV IgM seropositive. The Anti-HEV was distributed in all the study age groups. The blood donors aged 20-29 years reported of 4.5% IgM and 5.5% IgG seroprevalence rate compared to other age groups. HEV seroprevalence was statistically significant higher in males and donors with tertiary level of education. Based on RT-PCR, all the seropositive samples were HEV RNA negative. Therefore, the study was unable to determine the Hepatitis E virus genotypes circulating in Kenya. This study shows that in Nairobi, there is high HEV seroprevalence among healthy blood donors. Further studies among other population groups are desirable to evaluate the potential benefits of incorporating screening of HEV among blood donors.