Background: Hepatitis E virus (HEV) is a hepatotropic pathogen that causes significant morbidity and mortality in humans. It is an important causative agent of viral hepatitis outbreaks. This study investigates the serological and molecular prevalence of HEV in blood donors attending the Central Blood Bank in Wad Medani City in Gezira State, Sudan.

Methods: The study adopted a cross-sectional descriptive design. A structured questionnaire was used to collect data concerning demographic information and risk factors associated with HEV transmission. All enrolled participants (N = 300) were screened for HEV IgG antibodies using commercial ELISA kits, then strong positive samples (N = 84) were selected and rescreened for HEV IgM and HEV RNA by RT PCR. SPSS version 24.0 was used for analysis.

Results: Out of 300 male participants, 36.3% (109/300) were positive for HEV IgG. However, only one participant was IgM positive, while the HEV RNA was negative. The highest prevalence rates of the virus were 42 (44.6%) among the age group of 31–40 years, 20 (48.8%) in those who consumed food from outside, 13 (50%) in three to four multiple blood donations, and 5 (62.5%) in those who consumed water from the river source. A significant association of HEV IgG prevalence concerning the occupation of the participants being students or farmers was detected using univariate and multivariate analysis (P-value = 0.007).

Conclusion: High prevalence of HEV IgG was demonstrated among the healthy blood donors in this study. Given the possibility of HEV transmission by transfusion from donors to recipients, we recommend that routine screening for HEV should be adopted by blood banks in Sudan.

[2] Modrow, S., Falke, D., Truyen, U., & Schätzl, H. (2013). Viruses with single-stranded, segmented, negative-sense RNA genomes. Molecular Virology. Springer.

[3] Smith, D. B., Simmonds, P., Jameel, S., Emerson, S. U., Harrison, T. J., Meng, X. J., Okamoto, H., Van der Poel, W. H. M., Purdy, M. A., & the Members Of The International Committee On The Taxonomy Of Viruses Study Group. (2014). Consensus proposals for classification of the family Hepeviridae. The Journal of General Virology, 95(Pt 10), 2223–2232. https://doi.org/10.1099/vir.0.068429-0

[4] Abdel Hady, S. I., El-Din, M. S., & El-Din, M. E. (1998). A high hepatitis E virus (HEV) seroprevalence among unpaid blood donors and haemodialysis patients in Egypt. The Journal of the Egyptian Public Health Association, 73(3–4), 165–179.

[5] Houcine, N., Jacques, R., Salma, F., Anne-Gaëlle, D., Amin, S., Mohsen, H., Hamadi, B., Christophe, R., Patrice, A., Mahjoub, A., & Caroline, S. (2012). Seroprevalence of hepatitis E virus infection in rural and urban populations, Tunisia. Clinical Microbiology and Infection, 18(5), E119–E121. https://doi.org/10.1111/j.1469- 0691.2012.03793.x

[6] Ben Halima, M., Arrouji, Z., Slim, A., Lakhoua, R., & Ben Redjeb, S. (1998). [Epidemiology of hepatitis E in Tunisia]. La Tunisie Medicale, 76(5), 129–131.

[7] Traoré, K. A., Rouamba, H., Nébié, Y., Sanou, M., Traoré, A. S., Barro, N., & Roques, P. (2012). Seroprevalence of fecal-oral transmitted hepatitis A and E virus antibodies in Burkina Faso. PLoS One, 7(10), e48125. https://doi.org/10.1371/journal.pone.0048125

[8] Adjei, A. A., Tettey, Y., Aviyase, J. T., Adu-Gyamfi, C., Obed, S., Mingle, J. A., Ayeh-Kumi, P. F., & Adiku, T. K. (2009). Hepatitis E virus infection is highly prevalent among pregnant women in Accra, Ghana. Virology Journal, 6(1), 108. https://doi.org/10.1186/1743-422X-6-108

[9] Slot, E., Hogema, B. M., Riezebos-Brilman, A., Kok, T. M., Molier, M., & Zaaijer, H. L. (2013). Silent hepatitis E virus infection in Dutch blood donors, 2011 to 2012. Eurosurveillance, 18(31), 20550. https://doi.org/10.2807/1560-7917.ES2013.18.31.20550

[10] Faber, M. S., Wenzel, J. J., Jilg, W., Thamm, M., Höhle, M., & Stark, K. (2012). Hepatitis E virus seroprevalence among adults, Germany. Emerging Infectious Diseases, 18(10), 1654–1657. https://doi.org/10.3201/eid1810.111756

[11] Huzly, D., Umhau, M., Bettinger, D., Cathomen, T., Emmerich, F., Hasselblatt, P., Hengel, H., Herzog, R., Kappert, O., Maassen, S., Schorb, E., Schulz-Huotari, C., Thimme, R., Unmüssig, R., Wenzel, J. J., & Panning, M. (2014). Transfusiontransmitted hepatitis E in Germany, 2013. Eurosurveillance, 19(21), 208–212. https://doi.org/10.2807/1560-7917.ES2014.19.21.20812

[12] Mitsui, T., Tsukamoto, Y., Suzuki, S., Yamazaki, C., Masuko, K., Tsuda, F., Takahashi, M., Tsatsralt-Od, B., Nishizawa, T., & Okamoto, H. (2005). Serological and molecular studies on subclinical hepatitis E virus infection using periodic serum samples obtained from healthy individuals. Journal of Medical Virology, 76(4), 526–533. https://doi.org/10.1002/jmv.20393

[13] Tamura, A., Shimizu, Y. K., Tanaka, T., Kuroda, K., Arakawa, Y., Takahashi, K., Mishiro, S., Shimizu, K., & Moriyama, M. (2007). Persistent infection of hepatitis E virus transmitted by blood transfusion in a patient with T-cell lymphoma. Hepatology Research, 37(2), 113–120. https://doi.org/10.1111/j.1872-034X.2007.00024.x

[14] Colson, P., Coze, C., Gallian, P., Henry, M., De Micco, P., & Tamalet, C. (2007). Transfusion-associated hepatitis E, France. Emerging Infectious Diseases, 13(4),648–649. https://doi.org/10.3201/eid1304.061387

[15] Féray, C., Pawlotsky, J. M., Roque-Afonso, A. M., Samuel, D., & Dhumeaux, D. (2014). Should we screen blood products for hepatitis E virus RNA? Lancet, 383(9913), 218. https://doi.org/10.1016/S0140-6736(14)60072-6

[16] Arankalle, V. A., & Chobe, L. P. (1999). Hepatitis E virus: Can it be transmitted parenterally? Journal of Viral Hepatitis, 6(2), 161–164. https://doi.org/10.1046/j.1365- 2893.1999.00141.x

[17] Khuroo, M. S., Kamili, S., & Yattoo, G. N. (2004). Hepatitis E virus infection may be transmitted through blood transfusions in an endemic area. Journal of Gastroenterology and Hepatology, 19(7), 778–784. https://doi.org/10.1111/j.1440- 1746.2004.03437.x

[18] Ibrahim, E., Abdelwahab, S., Nady, S., Hashem, M., Galal, G., Sobhy, M., Saleh, A. S., & Shata, M. T. Prevalence of anti-HEV IgM among blood donors in Egypt. (2010). The Egyptian Journal of Immunology/Egyptian Association of Immunologists, 18(2), 47–58.

[19] Meldal, B. H., Sarkodie, F., Owusu-Ofori, S., & Allain, J. P. (2013). Hepatitis E virus infection in Ghanaian blood donors – The importance of immunoassay selection and confirmation. Vox Sanguinis, 104(1), 30–36. https://doi.org/10.1111/j.1423- 0410.2012.01637.x

[20] Baylis, S. A., Gärtner, T., Nick, S., Ovemyr, J., & Blümel, J. (2012). Occurrence of hepatitis E virus RNA in plasma donations from Sweden, Germany and the United States. Vox Sanguinis, 103(1), 89–90. https://doi.org/10.1111/j.1423-0410.2011.01583.x

[21] Guo, Q. S., Yan, Q., Xiong, J. H., Ge, S. X., Shih, J. W., Ng, M. H., Zhang, J., & Xia, N. S. (2010). Prevalence of hepatitis E virus in Chinese blood donors. Journal of Clinical Microbiology, 48(1), 317–318. https://doi.org/10.1128/JCM.01466-09

[22] Fischer, C., Hofmann, M., Danzer, M., Hofer, K., Kaar, J., & Gabriel, C. (2015). Seroprevalence and Incidence of hepatitis E in blood donors in Upper Austria. PLoS One, 10(3), e0119576. https://doi.org/10.1371/journal.pone.0119576

[23] Babiker, N. A., Abakar, A. D., Taha, M. A., & Mohamed, N. T. (2019). Sero-Molecular Epidemiology of Hepatitis E Virus among Hemodialysis. Jouf University Medical Journal, 6(3), 9–16.

[24] Naeimi, B., Kalimani, F. M., & Pourfatolah, A. A. (2015). Hepatitis E virus seroprevalence among blood donors in Bushehr, South of Iran. Hepa Month, 15(11).

[25] Ahmed, A. B., & Hamedelnil, Y. F. (2015). Seroprevalence of hepatitis E virus among blood donors in Omdurman locality, Sudan. American Journal of Research Communication, 3(5), 252–258.