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• Co-infection with hepatitis E virus (HEV) was investigated in two cohorts of HIV-infected persons (n = 2506). • A stable HEV seroprevalence of 23% was found over three decades from the 1980s to 2013. • Age, HIV risk group, and geographical origin were associated with anti-HEV immunoglobulin G positivity. • No evidence of persistent HEV RNA was found in 57 anti-HEV seroconverting persons. Hepatitis E virus (HEV) genotype 3 is endemic in Europe, and the infection is mostly subclinical or acute and self-limiting. However, persistent infection is described among HIV-infected individuals. The prevalence of antibodies against HEV (anti-HEV) among HIV-infected persons varies geographically and is unknown in Denmark. Rates of co-infection with HEV among HIV-infected individuals in Denmark over three decades, from the early 1980s to 2013, were investigated. A total of 2506 HIV-infected persons were investigated from two cohorts followed at Hvidovre Hospital, Denmark. Blood samples were tested retrospectively for anti-HEV, including samples from 2216 persons who were enrolled in a prospective clinical cohort and followed between 1995 and 2013, as well as samples from 290 persons from a historical cohort followed between 1980 and 1994. For anti-HEV seroconverting individuals, serial samples were tested for HEV RNA. Factors associated with anti-HEV status were explored using multivariable logistic regression analysis. The overall HEV seroprevalence rates were stable during the 1980s, 1990s, and 2000–2013 (23.1%, 22.9%, and 23.7%, respectively). In all decades, rates of anti-HEV increased with older age, and anti-HEV seropositivity was associated with older generations, HIV risk group, and geographic origin. Persistent HEV infection was not detected in any of 57 individuals with anti-HEV seroconversion. HEV seroprevalence rates were stable in HIV-infected individuals from the early 1980s to 2013. Rates increased with age. No evidence of persistent HEV infection was detected. Infection with HEV is frequent, but persistent HEV infection is rare among HIV-infected individuals. [ABSTRACT FROM AUTHOR]

Background Occult hepatitis B virus ( HBV) infection ( OBI) is identified in 1:1000 to 1:50,000 European blood donations. This study intended to determine the infectivity of blood products from OBI donors. Study Design and Methods Recipients of previous donations from OBI donors were investigated through lookback (systematic retrieval of recipients) or traceback (triggered by clinical cases). Serologic and genomic studies were undertaken on consenting donors and recipients. Multiple variables potentially affecting infectivity were examined. Results A total of 45 of 105 (42.9%) donor-recipients pairs carried antibodies to HBV core (anti- HBc) as evidence of previous HBV infection. Subtracting 15% of anti- HBc population background, the adjusted transmission rate was 28%. Anti- HBc prevalence increased to 28 of 44 (63.8%) in unvaccinated recipients receiving anti- HBs-negative OBI blood products. In contrast, four of 26 (15.4%) recipients of anti- HBs-positive products were anti- HBc positive. Transmission with anti- HBs-negative products depended on volume of plasma transfused (85%-100% with 200 mL of fresh frozen plasma [ FFP], 51% with 50 mL in platelet concentrates [ PCs], and 24% with 20 mL in red blood cells [ RBCs], p < 0.0001 FFP vs. RBCs). The 50% minimum infectious dose of OBI HBV DNA was estimated at 1049 (117-3441) copies. Donor and recipient strains sequence homology of at least 99% confirmed transfusion-transmitted infection in 10 cases and excluded it in one case. Conclusion Blood products from donors with OBI carry a high risk of HBV transmission by transfusion. This risk is dependent on presence of anti- HBs and viral dose. This may justify safety measures such as anti- HBc and HBV nucleic acid test screening depending on epidemiology. [ABSTRACT FROM AUTHOR]