A Valuable Antigen Detection Method for Diagnosis of Acute Hepatitis E

Hepatitis E virus (HEV) is a serious public health problem. The commonly used tests that are specific for current HEV infection diagnosis include the detection of anti-HEV IgM and HEV RNA. Here, we report an improved enzyme-linked immunosorbent assay (ELISA) method for HEV antigen detection with a linear range equivalent to 6.3 × 103to 9.2 × 105RNA copies per ml. The monoclonal antibody (MAb) 12F12, a high-ability MAb that binds HEV virus, was selected as the capture antibody from a panel of 95 MAbs. The positive period of HEV antigenemia in infected monkeys using this test was, on average, 3 weeks longer than previously reported and covered the majority of the acute phase. The positive detection rates of IgM, RNA, and new antigen from the first serum samples collected from 16 confirmed acute hepatitis E patients were 81% (13/16), 81% (13/16), and 100% (16/16), respectively. In three patients, the initial serum specimens that tested negative for IgM, despite the presence of symptoms of acute hepatitis and elevated alanine aminotransferase (ALT) levels, were positive for HEV antigen and HEV RNA. In contrast, the serum samples of the three RNA-negative patients were antigen positive (and IgM positive), possibly due to the degradation of HEV nucleic acids. Our results suggest that this new antigen detection method has acceptable concordance with RNA detection and could serve as an important tool for diagnosing acute hepatitis E.

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Bovine Serum Albumin Antibodies as a Disease Marker for Hepatitis E Virus Infection

Journal of Biomedicine and Biotechnology ◽

10.1155/jbb.2005.316 ◽

2005 ◽

Vol 2005 (4) ◽

pp. 316-321 ◽

Cited By ~ 4

Author(s):

Medhat Haroun

Keyword(s):

Bovine Serum Albumin ◽

Serum Albumin ◽

Acute Hepatitis ◽

Bovine Serum ◽

Hepatitis E ◽

Serum Samples ◽

Disease Marker ◽

Normal Individuals ◽

Significant Difference ◽

Acute Hepatitis E

This report evaluates the significance of antibody/bovine serum albumin (BSA) interactions as a risk factor for the diagnosis of acute hepatitis E. Serum samples from 40 patients with acute hepatitis E and from 40 age/sex matched healthy adult subjects were tested for IgA, IgG, and IgM by ELISA and by turbidimetric assay. BSA was used as a target to characterize changes in levels of interacting immunoglobulins. Initial results obtained before removal of antibodies that interacted with BSA suggested that HEV patients had increased levels of IgM in their sera. It was found that normal individuals had mean IgA, IgG, and IgM levels of2.55mg/mL,9.80mg/mL, and1.73mg/mL, respectively while HEV patients had mean levels of2.66mg/mL,10.04mg/mL, and2.01mg/mL (P<.26,P<.32, andP<.0004). However, the mean level of IgM in HEV-infected sera after purification from antibodies that interacted with BSA was determined to be1.72mg/mL indicating that there was no significant difference in IgM level in HEV patients compared to normal individuals (P<.6). The presence of antibodies that interact with BSA might serve as a diagnostic tool for detection of high-risk patients.

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Hepatitis E virus in Italy: molecular analysis of travel-related and autochthonous cases

Journal of General Virology ◽

10.1099/vir.0.031278-0 ◽

2011 ◽

Vol 92 (7) ◽

pp. 1617-1626 ◽

Cited By ~ 45

Author(s):

Giuseppina La Rosa ◽

Michele Muscillo ◽

Valentina Spuri Vennarucci ◽

Anna Rosa Garbuglia ◽

Patrizia La Scala ◽

...

Keyword(s):

Acute Hepatitis ◽

Hepatitis E Virus ◽

Hepatitis E ◽

The Body ◽

Industrialized Countries ◽

Genotype 3 ◽

Serum Samples ◽

Specific Primers ◽

Body Of Knowledge ◽

Acute Hepatitis E

Human hepatitis E virus (HEV) is considered an emerging pathogen in industrialized countries. The aim of the present study was to contribute to the body of knowledge available on the molecular epidemiology of acute hepatitis E in Italy. Three sets of HEV-specific primers targeting the ORF1 and ORF2 were used to examine serum samples collected from acute hepatitis patients positive for anti-HEV IgG and/or IgM, between 2007 and 2010. Seventeen patients (39.5 %) tested HEV RNA-positive: 12 infections, due to genotype 1, were associated with travel to endemic areas (Bangladesh, India and Pakistan), while five infections, due to genotype 3, were presumably autochthonous. Risk factors identified in this group included exposure to raw seafood, pork liver sausages and wild boar. Results from the present study confirm that human HEV infection in Italy is caused by different genotypes, depending on whether the infection is travel-related or autochthonous.

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Comparison of a New Immunochromatographic Test to Enzyme-Linked Immunosorbent Assay for Rapid Detection of Immunoglobulin M Antibodies to Hepatitis E Virus in Human Sera

Clinical and Diagnostic Laboratory Immunology ◽

10.1128/cdli.12.5.593-598.2005 ◽

2005 ◽

Vol 12 (5) ◽

pp. 593-598 ◽

Cited By ~ 32

Author(s):

Hsiao Ying Chen ◽

Yang Lu ◽

Teresa Howard ◽

David Anderson ◽

Priscilla Yiquan Fong ◽

...

Keyword(s):

Acute Hepatitis ◽

Immunosorbent Assay ◽

Predictive Value ◽

Rapid Detection ◽

Hepatitis E Virus ◽

Rapid Test ◽

Hepatitis E ◽

Enzyme Linked Immunosorbent Assay ◽

Immunochromatographic Test ◽

Acute Hepatitis E

ABSTRACT An immunochromatographic test for rapid detection of IgM antibodies in patients with acute hepatitis E infection was developed utilizing the well-characterized recombinant protein EP2.1 and monoclonal antibody 4B2. The new rapid test based on a novel reverse-flow technology was able to generate a positive result within 2 to 3 min. Our study showed that this test was able to detect anti-HEV IgM antibodies in 96.7% of the patient samples tested (n = 151) while maintaining an excellent specificity of 98.6% with samples from various patient or healthy control groups (total n = 208). Furthermore, this rapid test gave a good specificity of 90.9% when tested with rheumatoid factor (RF)-positive sera (RF value of ≤850 IU/ml; n = 11) although a higher concentration of RF in samples might cause cross-reactivity. The new test has a good agreement of 97.2% with a kappa value of 0.943 when compared with a reference enzyme-linked immunosorbent assay. The positive predictive value and the negative predictive value for the rapid test thus reached 98.0 and 97.6%, respectively. This is the first rapid, point-of-care test for hepatitis E and will be especially useful for the diagnosis of acute hepatitis E virus infection in field and emergency settings and in resource-poor countries.

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Seroprevalence of Hepatitis E Virus (HEV) Infection Among Patients Attending BSMMU, Dhaka

Bangladesh Journal of Medical Microbiology ◽

10.3329/bjmm.v1i2.21509 ◽

2016 ◽

Vol 1 (2) ◽

pp. 52-55

Author(s):

Ayesha Begum ◽

Shahina Tabassum ◽

Md. Nazrul Islam ◽

Ms Afzalunnessa

Keyword(s):

Urban Areas ◽

Hepatitis E Virus ◽

Public Health Problem ◽

Hepatitis E ◽

Enzyme Linked Immunosorbent Assay ◽

Age Group ◽

Serum Samples ◽

Rural And Urban Areas ◽

Rural And Urban ◽

Study Population

The present study was done to determine the seroprevalence of the infection by Hepatitis E virus (HEV) among patients attending Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka. Serum samples from 408 subjects, aged between 0-69 years, attending BSMMU from different rural and urban areas of Bangladesh were tested for HEV IgG by enzyme linked immunosorbent assay (ELISA). Anti-HEV IgG was found among 20.6% of the study population. A higher rate of seropositivity (26.1%) was found among patients attending from urban than those from rural (15.1%) areas which is statistically significant (P < 0.01). A gradual rise in prevalence of anti-HEV IgG was observed among the study population according to age, starting from 10.6% in the 0-9 years age group and increasing with higher age thereafter. The HEV IgG prevalence reached its highest (28.3%) in the 30-39 years, which remained at around the same level in the 40-49 years (25.0%) and 50-59 years (26.0%), with a drop of incidence in the 60-69 years age group (17.8%). The study indicates HEV infection as a public health problem in Bangladesh and suggests to ensure increased awareness to prevent andcontrol future outbreaks.Bangladesh J Med Microbiol 2007; 01 (02): 52-55

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Lower Levels of Transaminases but Higher Levels of Serum Creatinine in Patients with Acute Hepatitis E in Comparison to Patients with Hepatitis A

Pathogens ◽

10.3390/pathogens10010060 ◽

2021 ◽

Vol 10 (1) ◽

pp. 60

Author(s):

Thomas Theo Brehm ◽

Omid Mazaheri ◽

Thomas Horvatits ◽

Marc Lütgehetmann ◽

Julian Schulze zur Wiesch ◽

...

Keyword(s):

Serum Creatinine ◽

Acute Hepatitis ◽

Hepatitis A ◽

Medical Center ◽

Hepatitis E ◽

Distribution Width ◽

Lymphocyte Ratio ◽

Median Serum ◽

Acute Hepatitis E ◽

Hematological Manifestations

In patients with hepatitis E virus (HEV) infections, extrahepatic, particularly renal and hematological manifestations, are increasingly reported in the medical literature but have never been studied compared to a control cohort. We retrospectively analyzed medical records of consecutive patients that were diagnosed with acute hepatitis E (AHE) (n = 69) or acute hepatitis A (AHA) (n = 46) at the University Medical Center Hamburg Eppendorf from January 2009 to August 2019 for demographical, clinical, and laboratory information. Patients with AHE had significantly lower median levels of ALAT (798 U/L) and total bilirubin (1.8 mg/dL) compared to patients with AHA (2326 U/L; p < 0.001 and 5.2 mg/dL; p < 0.001), suggesting a generally less severe hepatitis. In contrast, patients with AHE had significantly higher median serum creatinine levels (0.9 mg/dL vs. 0.8 mg/dL; p = 0.002) and lower median estimated glomerular filtration rate (eGFR) (91 mL/min/1.73 m2 vs. 109 mL/min/1.73 m2; p < 0.001) than patients with AHA. Leucocyte, neutrophil and lymphocyte count, hemoglobin, platelets, red cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR), and RDW to lymphocyte ratio (RLR) did not differ between patients with AHE and those with AHA. Our observations indicate that renal but not hematological interference presents an underrecognized extrahepatic feature of AHE, while inflammation of the liver seems to be more severe in AHA.

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