{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T00:14:41Z","timestamp":1793060081062,"version":"4.5.0"},"reference-count":47,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T00:00:00Z","timestamp":1703721600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>More than 45 cases of transfusion\u2010transmitted hepatitis E virus infection (TT\u2010HEV) have been reported in Japan. Therefore, in 2020, universal individual donation nucleic acid amplification testing (ID\u2010NAT) was implemented for HEV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design and Methods<\/jats:title><jats:p>We characterized HEV NAT\u2010positive blood donors. The number of new HEV infections and the asymptomatic infection rate were estimated using the HEV NAT\u2010positive rate. HEV RNA quantitation, phylogenetic analysis, and antibody tests were performed, and the residual risk of TT\u2010HEV was assessed based on the lookback study results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 5,075,100 blood donations were screened with ID\u2010NAT during the first year of implementation, among which 2804 (0.055%; males: 0.060%, females: 0.043%) were NAT\u2010positive with regional differences. Approximately 270,000 new HEV infection cases were estimated to occur annually in Japan, with an asymptomatic infection rate of 99.9%. The median HEV RNA concentration, excluding cases below the limit of quantification, was 205\u2009IU\/mL. Among the 1113 cases where the genotype could be determined, HEV\u20103 and HEV\u20104 accounted for 98.8% (1100) and 1.2% (13), respectively. The maximum duration of HEV viremia, including the pre\u2010 and post\u2010ID\u2010NAT window periods, was estimated to be 88.2\u2009days. Within the 3\u2009years since ID\u2010NAT implementation, no confirmed cases of breakthrough TT\u2010HEV were observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Multiple indigenous HEV strains are prevalent in Japan, infecting a significant number of individuals. However, since the implementation of ID\u2010NAT, TT\u2010HEV has been prevented due to the test's high sensitivity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.17696","type":"journal-article","created":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T10:09:22Z","timestamp":1703758162000},"page":"335-347","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Universal nucleic acid donor screening revealed epidemiological features of hepatitis <scp>E<\/scp> and prevented transfusion\u2010transmitted infection in <scp>Japan<\/scp>"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3338-3960","authenticated-orcid":false,"given":"Ami","family":"Tanaka","sequence":"first","affiliation":[{"name":"Central Blood Institute, Blood Service Headquarters Japanese Red Cross Society  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiji","family":"Matsubayashi","sequence":"additional","affiliation":[{"name":"Central Blood Institute, Blood Service Headquarters Japanese Red Cross Society  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Odajima","sequence":"additional","affiliation":[{"name":"Central Blood Institute, Blood Service Headquarters Japanese Red Cross Society  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6879-4124","authenticated-orcid":false,"given":"Hidekatsu","family":"Sakata","sequence":"additional","affiliation":[{"name":"Japanese Red Cross Hokkaido Block Blood Center  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juri","family":"Iida","sequence":"additional","affiliation":[{"name":"Japanese Red Cross Hokkaido Block Blood Center  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Kai","sequence":"additional","affiliation":[{"name":"Blood Service Headquarters Japanese Red Cross Society  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoko","family":"Goto","sequence":"additional","affiliation":[{"name":"Blood Service Headquarters Japanese Red Cross Society  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4660-6839","authenticated-orcid":false,"given":"Masahiro","family":"Satake","sequence":"additional","affiliation":[{"name":"Central Blood Institute, Blood Service Headquarters Japanese Red Cross Society  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,28]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1099\/jgv.0.001778"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1099\/jgv.0.001435"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.94.18.9860"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1112.051041"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14025-1"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2307.170318"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1338113"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.12175"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2008.01722.x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.42.11.5371-5374.2004"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.virusres.2021.198645"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2801.211466"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2018.05.013"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2016.21.35.30332"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61034-5"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2011.02.050"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0706992"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-03-492363"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2004.03300.x"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.16700"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2008.01910.x"},{"key":"e_1_2_9_23_1","unstructured":"Held on August 3.1st Blood Business Subcommittee Safety Technology Subcommittee Pharmaceutical Affairs and Food Sanitation Council Blood Business Subcommittee Safety Technology Subcommittee Material Document 1.2016[cited 2023 Apr 05]. 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