scholarly journals Comprehensive Evaluation of Hepatitis E Serology and Molecular Testing in a Large Cohort

Pathogens ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. 137
Author(s):  
Olympia E. Anastasiou ◽  
Viktoria Thodou ◽  
Annemarie Berger ◽  
Heiner Wedemeyer ◽  
Sandra Ciesek
Keyword(s):  
Hepatitis E Virus ◽  
Clinical Laboratory ◽  
Comprehensive Evaluation ◽  
Cost Effective ◽  
Hepatitis E ◽  
Molecular Testing ◽  
Real World Setting ◽  
Immunosuppressed Patients ◽  
Immunocompromised Hosts ◽  
Time Point

Introduction: Reliable and cost-effective diagnostics for hepatitis E virus (HEV) infection are necessary. The aim of our study was to investigate which diagnostic test is most accurate to detect HEV infection in immunocompetent and immunosuppressed patients in a real world setting. Patients and Methods: We performed a retrospective analysis of 1165 patients tested for HEV antibodies and HEV PCR at the same time point. Clinical, laboratory and virological data were taken from patient charts. HEV IgA was measured in a subgroup of 185 patients. Results: HEV RNA was detectable in 61 patients (5.2%); most of them (n = 49, 80.3%/n = 43, 70.5%) were HEV IgM+ and IgG+; however, 12 patients (19.6%) were HEV RNA positive/HEV IgM negative and 17 patients (27.8%) were HEV RNA positive/HEV IgG negative. Ten HEV RNA positive patients (16.4%) had neither HEV IgG nor IgM antibodies. Importantly, all of them were immunosuppressed. HEV IgA testing was less sensitive than HEV IgM for HEV diagnosis. Conclusions: HEV infection can be overlooked in patients without HEV specific antibodies. Performing PCR is necessary to diagnose or exclude HEV infection in immunocompromised hosts. In immunocompetent patients, a screening based on HEV antibodies (IgG/IgM) is sufficient.

Transfusion-transmitted hepatitis E virus infections: a risk for immunosuppressed patients

2018 ◽  
Vol 56 (01) ◽  
pp. E2-E89
Author(s):  
D Westhölter ◽  
J Hartl ◽  
J Hiller ◽  
U Denzer ◽  
S Peine ◽  
...  
Keyword(s):  
Hepatitis E Virus ◽  
Hepatitis E ◽  
Virus Infections ◽  
Immunosuppressed Patients

scholarly journals Blood-borne Hepatitis E Virus Transmission: A Relevant Risk for Immunosuppressed Patients

2016 ◽  
Vol 63 (4) ◽  
pp. 569-570 ◽  
Author(s):  
Sven Pischke ◽  
Jens Hiller ◽  
Marc Lütgehetmann ◽  
Susanne Polywka ◽  
Meike Rybczynski ◽  
...  
Keyword(s):  
Hepatitis E Virus ◽  
Virus Transmission ◽  
Hepatitis E ◽  
Immunosuppressed Patients

scholarly journals Mystery of Hepatitis E Virus: Recent Advances in Its Diagnosis and Management

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Aftab Ahmed ◽  
Ijlal Akbar Ali ◽  
Hira Ghazal ◽  
Javid Fazili ◽  
Salman Nusrat
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis E Virus ◽  
Treatment Options ◽  
Antiviral Drug ◽  
Pegylated Interferon ◽  
Hepatitis E ◽  
Recent Advances ◽  
Immunosuppressed Patients ◽  
History Of ◽  
Acute And Chronic Hepatitis

Mysterious aspects of the long presumed to be well-known hepatitis E virus (HEV) have recently surfaced that distinguish it from other hepatotropic viruses. It is a cause of chronic hepatitis in immunosuppressed patients. It has human to human transmission through blood and mantains high seroprevalence in blood donors. HEV has also been found to occur more frequently in the West in those without a history of travel to endemic countries. It has varied extrahepatic manifestations and has multiple non-human reservoirs including pigs and rats. Considering these recent discoveries, it appears odd that HEV is not sought more frequently when working up acute and chronic hepatitis patients. The disease is particularly severe among pregnant women and has a high attack rate in young adults. What adds to its ambiguity is the absence of a well-established diagnostic criteria for its detection and that there is no specific antiviral drug for hepatitis E, except for isolated cases where ribavirin or pegylated interferon alpha has been used with occasional success. This review paper discusses the recent advances in the knowledge of the virus itself, its epidemiology, diagnostic approach and prevention, and the treatment options available.

scholarly journals Clinical phenotype and outcome of hepatitis E virus–associated neuralgic amyotrophy

Neurology ◽  
2017 ◽  
Vol 89 (9) ◽  
pp. 909-917 ◽  
Author(s):  
Jeroen J.J. van Eijk ◽  
Harry R. Dalton ◽  
Paolo Ripellino ◽  
Richard G. Madden ◽  
Catherine Jones ◽  
...  
Keyword(s):  
Liver Function ◽  
Brachial Plexus ◽  
Hepatitis E Virus ◽  
Clinical Laboratory ◽  
Clinical Phenotype ◽  
Hepatitis E ◽  
Genotype 3 ◽  
Laboratory Findings ◽  
Neuralgic Amyotrophy ◽  
Extensive Damage

Objective:To determine the clinical phenotype and outcome in hepatitis E virus–associated neuralgic amyotrophy (HEV-NA).Methods:Cases of NA were identified in 11 centers from 7 European countries, with retrospective analysis of demographics, clinical/laboratory findings, and treatment and outcome. Cases of HEV-NA were compared with NA cases without evidence of HEV infection.Results:Fifty-seven cases of HEV-NA and 61 NA cases without HEV were studied. Fifty-six of 57 HEV-NA cases were anti-HEV IgM positive; 53/57 were IgG positive. In 38 cases, HEV RNA was recovered from the serum and in 1 from the CSF (all genotype 3). Fifty-one of 57 HEV-NA cases were anicteric; median alanine aminotransferase 259 IU/L (range 12–2,961 IU/L); in 6 cases, liver function tests were normal. HEV-NA cases were more likely to have bilateral involvement (80.0% vs 8.6%, p < 0.001), damage outside the brachial plexus (58.5% vs 10.5%, p < 0.01), including phrenic nerve and lumbosacral plexus injury (25.0% vs 3.5%, p = 0.01, and 26.4% vs 7.0%, p = 0.001), reduced reflexes (p = 0.03), sensory symptoms (p = 0.04) with more extensive damage to the brachial plexus. There was no difference in outcome between the 2 groups at 12 months.Conclusions:Patients with HEV-NA are usually anicteric and have a distinct clinical phenotype, with predominately bilateral asymmetrical involvement of, and more extensive damage to, the brachial plexus. Involvement outside the brachial plexus is more common in HEV-NA. The relationship between HEV and NA is likely to be causal, but is easily overlooked. Patients presenting with NA should be tested for HEV, irrespective of liver function test results. Prospective treatment/outcome studies of HEV-NA are warranted.

scholarly journals Hepatitis E during Tocilizumab Therapy in a Patient with Rheumatoid Arthritis: Case Report and Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Hidekazu Ikeuchi ◽  
Kana Koinuma ◽  
Masao Nakasatomi ◽  
Toru Sakairi ◽  
Yoriaki Kaneko ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Chronic Hepatitis ◽  
Primary Infection ◽  
Hepatitis E Virus ◽  
Hepatitis E ◽  
Viral Reactivation ◽  
Normal Range ◽  
Rheumatoid Arthritis Case ◽  
Serum Samples ◽  
Immunocompromised Hosts

Hepatitis E is an acute self-limiting disease caused by hepatitis E virus (HEV). Recent reports show that HEV can induce chronic hepatitis or be reactivated in immunocompromised hosts. We report a 63-year-old woman with rheumatoid arthritis (RA) who developed hepatitis E during treatment with tocilizumab. Analysis of serially stocked serum samples confirmed that hepatitis was caused by primary infection with HEV and not by viral reactivation. Her liver function improved after discontinuing tocilizumab and remained within the normal range without reactivation of HEV for >5 years after restarting tocilizumab. We also reviewed the published cases of hepatitis E that developed during RA treatment.

scholarly journals Current Paradigm of Hepatitis E Virus Among Pediatric and Adult Patients

2021 ◽  
Vol 9 ◽  
Author(s):  
Oana Belei ◽  
Oana Ancusa ◽  
Adelina Mara ◽  
Laura Olariu ◽  
Elena Amaricai ◽  
...  
Keyword(s):  
Hepatitis E Virus ◽  
Hepatitis E ◽  
Published Data ◽  
Serological Tests ◽  
Vulnerable Patients ◽  
Lower Accuracy ◽  
Immunosuppressed Patients ◽  
Nucleic Acid Analysis ◽  
Limiting Condition ◽  
Current Paradigm

Hepatitis E virus (HEV) infection is a polymorphic condition, present throughout the world and involving children and adults. Multiple studies over the last decade have contributed to a better understanding of the natural evolution of this infection in various population groups, several reservoirs and transmission routes being identified. To date, acute or chronic HEV-induced hepatitis has in some cases remained underdiagnosed due to the lower accuracy of serological tests and due to the evolutionary possibility with extrahepatic manifestations. Implementation of diagnostic tests based on nucleic acid analysis has increased the detection rate of this disease. The epidemiological and clinical features of HEV hepatitis differ depending on the geographical areas studied. HEV infection is usually a self-limiting condition in immunocompetent patients, but in certain categories of vulnerable patients it can induce a sudden evolution toward acute liver failure (pregnant women) or chronicity (immunosuppressed patients, post-transplant, hematological, or malignant diseases). In acute HEV infections in most cases supportive treatment is sufficient. In patients who develop chronic hepatitis with HEV, dose reduction of immunosuppressive medication should be the first therapeutic step, especially in patients with transplant. In case of unfavorable response, the initiation of antiviral therapy is recommended. In this review, the authors summarized the essential published data related to the epidemiological, clinical, paraclinical, and therapeutic aspects of HEV infection in adult and pediatric patients.

Absence of occult Hepatitis E virus infection among HIV immunosuppressed patients

2015 ◽  
Vol 70 (6) ◽  
pp. 680-683 ◽  
Author(s):  
Antonio Rivero-Juarez ◽  
Loreto Martinez-Dueñas ◽  
Antonio Martinez-Peinado ◽  
Angela Camacho ◽  
Celia Cifuentes ◽  
...  
Keyword(s):  
Virus Infection ◽  
Hepatitis E Virus ◽  
Hepatitis E ◽  
Occult Hepatitis ◽  
Immunosuppressed Patients

Locally acquired hepatitis E virus in Marche Italy: Clinical/laboratory features and outcome

2020 ◽  
Vol 52 (4) ◽  
pp. 434-439 ◽  
Author(s):  
Giuseppe Tarantino ◽  
Alessio Ortolani ◽  
Katia Marinelli ◽  
Antonio Benedetti ◽  
Giulia Marconi ◽  
...  
Keyword(s):  
Hepatitis E Virus ◽  
Clinical Laboratory ◽  
Hepatitis E ◽  
Laboratory Features

scholarly journals Evaluation of a Novel CLIA Monotest Assay for the Detection of Anti-Hepatitis E Virus-IgG and IgM: A Retrospective Comparison with a Line Blot and an ELISA

Pathogens ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 689
Author(s):  
Karl Dichtl ◽  
Julia Zimmermann ◽  
Martin B. Koeppel ◽  
Stephan Böhm ◽  
Andreas Osterman
Keyword(s):  
Hepatitis E Virus ◽  
Cost Effective ◽  
Hepatitis E ◽  
Cross Reactivity ◽  
Antibody Detection ◽  
Emergency Setting ◽  
Analytical Sensitivity ◽  
Industrialized Countries ◽  
Retrospective Comparison ◽  
Sporadic Cases

Despite the increasing relevance of Hepatitis E, an emerging disease endemic in developing and with increasing numbers of sporadic cases in industrialized countries, commercial tests are mainly based on batch oriented serological assays. In this retrospective study, we compared a line immunoassay (LIA; recomLine HEV, Mikrogen) and an ELISA (EIA; Anti-Hepatitis E Virus ELISA, Euroimmun) with a novel chemoluminescence immunoassay in a monotest format (CLIA; Hepatitis E VirClia, Vircell). Twenty sera of PCR proven cases of hepatitis E and 68 blood samples serologically pre-characterized were included. Applying the WHO reference standard, the CLIA demonstrated the highest analytical sensitivity for IgG and IgM. The combinations of CLIA/EIA (IgG and IgM) and CLIA/LIA (IgG) measurements showed substantial correlation. Compared to overall antibody detection (seropositivity in ≥2 assays), CLIA correlation was excellent, outperforming LIA (IgM) and EIA (IgG and IgM). Minor IgM cross reactivity in samples of patients with acute EBV infection was observed in all three assays. The CLIA showed good performance in diagnostic samples compared to established LIA and EIA assays. Due to its ready-to-use monotest format, the CLIA allows simple, time- and cost-effective handling of single samples. These qualities make the assay suitable for diagnostics, especially in the emergency setting and for low-throughput laboratories.

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