Introduction: Hepatitis E is caused by hepatitis E virus (HEV), with varying clinical appearances ranging from asymptomatic cases to acute liver failure, particularly in immunocompromised individuals and pregnant women. In Pakistan, despite evidence of transfusion-transmitted HEV infections, routine HEV RNA blood donor screening is not practiced. This study investigates the prevalence of HEV IgM, IgG antibodies, and RNA among blood donors in Mirpur, Azad Jammu & Kashmir (AJK), to assess their potential role as HEV carriers.

Methodology: This cross-sectional study, conducted at the Mirpur Regional Blood Centre, evaluated 3,480 blood donors from October to December 2023. Blood samples were screened for anti-HEV IgG and IgM immunoglobulins using Wantai ELISA, with reactive IgM samples subjected to HEV RNA detection via nested RT-qPCR. Donor demographics and medical histories were collected. Statistical analyses were performed using SPSS, with a significance threshold of p ≤ 0.05.

Results: Anti-HEV IgG and IgM antibodies were detected in 9.25% and 1.03% of donors, respectively, with an overall HEV seroprevalence of 10.28%. HEV RNA was found in 0.11% of samples. Past infection rates increased significantly with age but showed no gender differences. All HEV RNA-positive donors were asymptomatic males, predominantly aged >30 years.

Conclusion: The study highlights the presence of recent HEV infections (1.03%) and potential transfusion-transmission risk. While no direct evidence of transfusion-transmitted HEV was observed, implementing HEV RNA screening in blood banks is recommended to enhance transfusion safety, especially for immunocompromised patients.

Key words: Hepatitis E Virus, Transfusion-transmitted, RNA,