Genotypic distribution of hepatitis E virus among asymptomatic blood donors and its impact on transfusion safety

Hepatitis E virus is an emerging transfusion transmissible infectious disease of public health concern. Understanding the predominant genotype is crucial for implementing screening techniques and comprehending viral dynamics. Therefore, this study was conducted to investigate the presence of detectable HEV-RNA among the asymptomatic blood donors to identify the prevalent HEV genotype. Serologically HEV IgM reactive samples from asymptomatic voluntary blood donors were screened for HEV RNA using real-time RT-PCR. Additionally, modified Sanger sequencing and phylogenetic analysis were conducted to determine the prevalent genotype. Of the 27 seroreactive samples, two (7 %) had detectable viremia with a high Ct value. Sequence analysis confirmed both HEV RNA-positive samples as genotype 1, the only human-infecting genotype in India. Existing literature reports HEV seroprevalence among Indian blood donors as high as 60 %, with HEV RNA detected in approximately 1 in 1864 donations. Transfusion-transmitted HEV (TT-HEV) can be effectively prevented through blood unit screening. Estimating the Hepatitis E disease burden across different regions and identifying prevalent genotypes among blood donors and at-risk populations are crucial for guiding the effective implementation of an HEV screening policy.