Multiple Factors Contribute to Positive Results for Hepatitis A Virus Immunoglobulin M Antibody

2013 ◽  
Vol 137 (1) ◽  
pp. 90-95 ◽  
Author(s):  
Adnan Alatoom ◽  
M. Qasim Ansari ◽  
Jennifer Cuthbert
Keyword(s):  
Liver Disease ◽  
Acute Hepatitis ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Laboratory Data ◽  
The United States ◽  
Immunoglobulin M ◽  
Order Entry ◽  
Igm Antibody ◽  
Positive Results

Context.—In the United States, a successful vaccination program for hepatitis A virus (HAV) infection has decreased both its incidence and the true positive rate for diagnostic immunoglobulin M (IgM) antibody to HAV in acute hepatitis. Objective.—To survey positive results of HAV IgM tests and determine the effect of changing ordering options. Design.—We reviewed all positive results for IgM antibody to HAV between January 2007 and December 2010. Patient demographics, clinical history, and laboratory data were recorded and the encounter, order, and reason for test reviewed. Each result was categorized as indicating acute, recent, resolved, or indeterminate HAV infection. Results.—A total of 10 735 tests were performed; 35 patients had 49 positive results. Most positive test results were associated with outpatient visits and were ordered in the assessment of patients with liver disease, but not clinical acute hepatitis. In the final analysis, 4 patients had acute hepatitis A and 20 individual patients had recent and/or resolved hepatitis. All but 1 of the remaining 11 patients had another established cause of liver disease with a positive IgM HAV antibody test result; data to determine causality were insufficient. The total number of tests requested annually decreased more than 35% with the introduction of computerized physician order entry. Conclusions.—Current assays for IgM HAV antibodies are overused in the absence of clinical acute hepatitis; future clinical decision support may improve patterns of order entry. Most patients have findings consistent with HAV exposure but not acute hepatitis; dormant viral infection may be a continuing source of antigen.

Viral Hepatitis A

2021 ◽  
Author(s):  
Kenrad E Nelson ◽  
Brittany L Kmush
Keyword(s):  
United States ◽  
Acute Hepatitis ◽  
Injection Drug Users ◽  
Drug Users ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Severe Disease ◽  
The United States ◽  
Childhood Immunization ◽  
Effective Prevention

Epidemics of infectious jaundice have been reported throughout recorded history. However, the proof that many of these outbreaks and individual cases of acute hepatitis were caused by a viral infection, the hepatitis A virus (HAV), did not appear until the 1960s. After the transmission of infection to marmosets and humans, the epidemiologic and virologic characteristics that differed between hepatitis A and hepatitis B virus infections were defined more clearly. After the development and licensure of hepatitis A vaccines in the 1990s, it became possible to implement an effective prevention program involving routine immunization of young children in the United States and several other Western countries. However, despite the dramatic efficacy of the childhood immunization program in reducing the incidence of acute hepatitis from HAV in the population, older children and adults remained susceptible. Significant morbidity continues to occur in the United States among international travelers, injection drug users, persons with underlying liver disease, and other high-risk populations. Since HAV is a global pathogen, the prevention of increasing morbidity from hepatitis A attributable to the incidence of clinically more severe disease increases in countries transitioning from high to intermediate or low endemic status is a major public health challenge. In this review, we discuss the epidemiology, virology, clinical characteristics, and prevention of hepatitis A infections. This review contains 8 figures, 3 tables and 89 references Key words: epidemiology, global impact, hepatitis A vaccine, hepatitis A virus, prevention, reservoirs, risk factors, treatment

scholarly journals Increasing incidence of hepatitis A in Bangladesh

2012 ◽  
Vol 47 (3) ◽  
pp. 309-312 ◽  
Author(s):  
MZ Amin ◽  
LN Siddique ◽  
MA Slatter ◽  
KK Biswas
Keyword(s):  
Liver Disease ◽  
High Risk ◽  
Chronic Liver Disease ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Age Groups ◽  
Hepatitis E ◽  
Immunoglobulin M ◽  
Chronic Liver ◽  
High Risk Population

Hepatitis A (HAV) infection is caused by the hepatitis A virus which is transmitted through the fecal-oral route. Life long protective antibodies are present after infection. The number of cases of adult hepatitis A has progressively been increasing during the last several decades in Bangladesh. In addition, the pattern of age-specific seroprevalence of anti-HAV has changed with economic growth. The prevalence of anti-HAV in 20-40 year age range has declined rapidly during the last 3 decades. As a result, this age groups has a high risk for HAV infection and clinically overt hepatitis A is increasing in adolescents and adult. The aim of the present study were to assess whether the proportion of adults with acute HAV infection has been increasing over the years and analyze the seroprevalence of immunoglobulin M(IgM) anti- HAV antibodies in young adults below the age of 20 years as well as in cases of chronic liver disease. Sera collected from 530 patients with acute and chronic liver disease attends the Somorita Hospital Ltd. during the previous 2 years and 6 months (Jan. 2008- Jun. 2010) were tested for various serological markers of acute and chronic hepatitis. In addition, 530 normal healthy attendants of the patients above the age of 20 years were tested for IgM anti-HAV as controls. Of 530 patients with acute hepatitis (13.42%) were positive for immunoglobulin M. The patients who were IgM anti-HAV negative were found to be hepatitis B (106 patients), hepatitis C, (10 patients), hepatitis E (150 patients) and unclassified (273 patients). Although the frequency of HAV infection among young adult (< 20 age) had increased (33.33% to 42.35%) in the 2 years and 6 months period, the frequency of HAV infection among adults had also increased (15.38% to 28.13%) during the same period. This study should be helpful for the identification of high risk population for vaccination of hepatitis A. DOI: http://dx.doi.org/10.3329/bjsir.v47i3.13065 Bangladesh J. Sci. Ind. Res. 47(3), 309-312 2012

Viral Hepatitis A

2021 ◽  
Author(s):  
Kenrad E Nelson ◽  
Brittany L Kmush
Keyword(s):  
United States ◽  
Acute Hepatitis ◽  
Injection Drug Users ◽  
Drug Users ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Severe Disease ◽  
The United States ◽  
Childhood Immunization ◽  
Effective Prevention

Epidemics of infectious jaundice have been reported throughout recorded history. However, the proof that many of these outbreaks and individual cases of acute hepatitis were caused by a viral infection, the hepatitis A virus (HAV), did not appear until the 1960s. After the transmission of infection to marmosets and humans, the epidemiologic and virologic characteristics that differed between hepatitis A and hepatitis B virus infections were defined more clearly. After the development and licensure of hepatitis A vaccines in the 1990s, it became possible to implement an effective prevention program involving routine immunization of young children in the United States and several other Western countries. However, despite the dramatic efficacy of the childhood immunization program in reducing the incidence of acute hepatitis from HAV in the population, older children and adults remained susceptible. Significant morbidity continues to occur in the United States among international travelers, injection drug users, persons with underlying liver disease, and other high-risk populations. Since HAV is a global pathogen, the prevention of increasing morbidity from hepatitis A attributable to the incidence of clinically more severe disease increases in countries transitioning from high to intermediate or low endemic status is a major public health challenge. In this review, we discuss the epidemiology, virology, clinical characteristics, and prevention of hepatitis A infections. This review contains 8 figures, 3 tables and 89 references Key words: epidemiology, global impact, hepatitis A vaccine, hepatitis A virus, prevention, reservoirs, risk factors, treatment

Viral Hepatitis A

2021 ◽  
Author(s):  
Kenrad E Nelson ◽  
Brittany L Kmush
Keyword(s):  
United States ◽  
Acute Hepatitis ◽  
Injection Drug Users ◽  
Drug Users ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Severe Disease ◽  
The United States ◽  
Childhood Immunization ◽  
Effective Prevention

Epidemics of infectious jaundice have been reported throughout recorded history. However, the proof that many of these outbreaks and individual cases of acute hepatitis were caused by a viral infection, the hepatitis A virus (HAV), did not appear until the 1960s. After the transmission of infection to marmosets and humans, the epidemiologic and virologic characteristics that differed between hepatitis A and hepatitis B virus infections were defined more clearly. After the development and licensure of hepatitis A vaccines in the 1990s, it became possible to implement an effective prevention program involving routine immunization of young children in the United States and several other Western countries. However, despite the dramatic efficacy of the childhood immunization program in reducing the incidence of acute hepatitis from HAV in the population, older children and adults remained susceptible. Significant morbidity continues to occur in the United States among international travelers, injection drug users, persons with underlying liver disease, and other high-risk populations. Since HAV is a global pathogen, the prevention of increasing morbidity from hepatitis A attributable to the incidence of clinically more severe disease increases in countries transitioning from high to intermediate or low endemic status is a major public health challenge. In this review, we discuss the epidemiology, virology, clinical characteristics, and prevention of hepatitis A infections. This review contains 8 figures, 3 tables and 89 references Key words: epidemiology, global impact, hepatitis A vaccine, hepatitis A virus, prevention, reservoirs, risk factors, treatment

Window period of anti-hepatitis A virus immunoglobulin M antibodies in diagnosing acute hepatitis A

2013 ◽  
Vol 25 (6) ◽  
pp. 665-668 ◽  
Author(s):  
Hyo Keun Lee ◽  
Kyung-Ah Kim ◽  
June Sung Lee ◽  
Nam-Hoon Kim ◽  
Won Ki Bae ◽  
...  
Keyword(s):  
Acute Hepatitis ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Immunoglobulin M ◽  
Window Period ◽  
Acute Hepatitis A

Solid-phase enzyme-linked immunosorbent assay for detection of hepatitis A-specific immunoglobulin M

1979 ◽  
Vol 9 (4) ◽  
pp. 459-465
Author(s):  
S A Locarnini ◽  
A G Coulepis ◽  
A M Stratton ◽  
J Kaldor ◽  
I D Gust
Keyword(s):  
Liver Disease ◽  
Immunosorbent Assay ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Solid Phase ◽  
Immunoglobulin M ◽  
Enzyme Linked Immunosorbent Assay ◽  
Dark Urine ◽  
Assay Procedure ◽  
Specific Immunoglobulin

A solid-phase enzyme linked immunosorbent assay was developed for the detection of immunoglobulin M antibody to hepatitis A virus. The system was capable of detecting hepatitis A-specific immunoglobulin M in a single dilution of serum and appears to be a reliable and rapid means of establishing a diagnosis of hepatitis A infection. Specific immunoglobulin M was only detected in patients with serologically confirmed hepatitis A and not in patients with other forms of hepatitis, chronic liver disease, or autoimmune disease. In patients with hepatitis A, specific immunoglobulin M was usually detectable for 6 weeks after the onset of dark urine, and the longest period for which it was present in any patient was 115 days. This enzyme-linked immunosorbent assay is rapid, simple to perform, and does not require complicated equipment. Provided adequate supplies of purified reagents can be obtained, this enzyme-linked immunosorbent assay procedure is likely to simplify hepatitis A serology, because the same antibody-coated plates can be utilized to detect hepatitis A virus, anti-hepatitis A virus, and hepatitis A-specific immunoglobulin M.

Viral Hepatitis A

2021 ◽  
Author(s):  
Kenrad E Nelson ◽  
Brittany L Kmush
Keyword(s):  
United States ◽  
Acute Hepatitis ◽  
Injection Drug Users ◽  
Drug Users ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Severe Disease ◽  
The United States ◽  
Childhood Immunization ◽  
Effective Prevention

Epidemics of infectious jaundice have been reported throughout recorded history. However, the proof that many of these outbreaks and individual cases of acute hepatitis were caused by a viral infection, the hepatitis A virus (HAV), did not appear until the 1960s. After the transmission of infection to marmosets and humans, the epidemiologic and virologic characteristics that differed between hepatitis A and hepatitis B virus infections were defined more clearly. After the development and licensure of hepatitis A vaccines in the 1990s, it became possible to implement an effective prevention program involving routine immunization of young children in the United States and several other Western countries. However, despite the dramatic efficacy of the childhood immunization program in reducing the incidence of acute hepatitis from HAV in the population, older children and adults remained susceptible. Significant morbidity continues to occur in the United States among international travelers, injection drug users, persons with underlying liver disease, and other high-risk populations. Since HAV is a global pathogen, the prevention of increasing morbidity from hepatitis A attributable to the incidence of clinically more severe disease increases in countries transitioning from high to intermediate or low endemic status is a major public health challenge. In this review, we discuss the epidemiology, virology, clinical characteristics, and prevention of hepatitis A infections. This review contains 8 figures, 3 tables and 89 references Key words: epidemiology, global impact, hepatitis A vaccine, hepatitis A virus, prevention, reservoirs, risk factors, treatment

scholarly journals Immunoglobulin M anti-hepatitis A virus determination reorienting gradient centrifugation for diagnosis of Acute Hepatitis A

1979 ◽  
Vol 9 (4) ◽  
pp. 476-478 ◽  
Author(s):  
G G Frösner ◽  
R Scheid ◽  
H Wolf ◽  
F Deinhardt
Keyword(s):  
Acute Hepatitis ◽  
Hepatitis A ◽  
Sucrose Gradient ◽  
Hepatitis A Virus ◽  
Gradient Centrifugation ◽  
Immunoglobulin M ◽  
Acute Hepatitis A ◽  
Sucrose Gradient Ultracentrifugation

The persistence of antibody to hepatitis A antigen (anti-HAV) of the immunoglobulin M (IgM) class was evaluated in 88 sera of 51 acute hepatitis A patients. IgM was separated from IgG by a 2-h reorienting sucrose gradient ultracentrifugation, and the titer of anti-HAV was determined in the IgG- and IgM-containing fractions by solid-hase radioimmunoassay. IgM anti-HAV was the predominating antibody at onset of jaundice and persisted in these patients for at least 60 days, but not longer than 115 days. The demonstration of IgM anti-HAV is therefore a valuable tool for the diagnosis of recent hepatitis A infection.

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