Molecular and serodetection of hepatitis E virus among organ donors in the Czech Republic

The prevalence of hepatitis E virus (HEV) infection in the Czech Republic is high, and HEV represents a potential risk for immunosuppressed organ transplant recipients. The aim of this study was to investigate the prevalence of anti-HEV IgG and IgM antibodies and the presence of HEV RNA in organ donors in the Czech Republic in order to assess the potential risk of HEV transmission. In this study, 73 organ donors sampled between 2022 and 2024 were examined. IgG and IgM antibodies against HEV were detected using an electrochemiluminescence immunoassay, and HEV RNA was assessed by molecular testing. A high prevalence of anti-HEV IgG antibodies (49.3%) and a low prevalence of anti-HEV IgM antibodies (2.7%) were observed. HEV RNA was not detected in any of the samples, indicating the absence of active infection. Higher donor age was significantly associated with anti-HEV IgG positivity (p = 0.046). The observed IgG prevalence was significantly higher than previously reported data from the Czech Republic based on samples collected in 2001. Despite the absence of detectable HEV RNA, the high prevalence of anti-HEV IgG antibodies indicates substantial HEV exposure among organ donors. These findings may inform discussion on HEV screening strategies for organ donors, particularly in settings with high background prevalence, with PCR testing serving as a confirmatory tool following serological screening. However, the relatively limited sample size and the absence of recipient follow-up data represent important limitations of this study. ClinicalTrials.gov ID: NCT06457438. The study used residual serum material from organ donors, which would have otherwise been disposed of. No pressure was exerted on the donors or their family members to agree to organ donation.