A new enzyme immunoassay for the detection of antibody to hepatitis E virus

Obriadina, Anna; Meng, Jianghui; Ulanova, T. I.; Trinta, Karen Soares; Burkov, A. N.; Ha, Fields; Ye, Khudyakov

doi:10.1046/j.1440-1746.17.s3.28.x

Cited by 29 publications

(20 citation statements)

References 30 publications

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“…These findings are consistent with other reports where genotype 1 antigens are found to react equally well with serum samples from both primates and patients infected with the four known genotypes of HEV (12,19). Although in general lower reactivity in HEV genotype 3-infected patients was seen compared to genotype 1 infections, we conclude that the currently used assays are acceptable for testing suspected genotype 1 and 3 HEV infections in patients in settings of low endemicity.…”

Section: Discussionsupporting

confidence: 92%

Use of Serological Assays for Diagnosis of Hepatitis E Virus Genotype 1 and 3 Infections in a Setting of Low Endemicity

Herremans

Bakker

Duizer

et al. 2007

Clin Vaccine Immunol

106

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Because of the occurrence of genotype 3 hepatitis E virus (HEV) in regions of low endemicity, it is important to validate the currently used serological assays for diagnosing infections with viruses belonging to this lineage, since these assays only use antigens derived from genotype 1 and 2 viruses. We evaluated the Genelabs enzyme-linked immunosorbent assay (ELISA) and the RecomBlot from Mikrogen for the detection of HEVspecific immunoglobulin M (IgM) and IgG under conditions of low endemicity. We compared test results of 16 patients with locally acquired genotype 3 HEV, 8 genotype 1 patients, 167 healthy controls from the general population, and 101 cases with hepatitis due to other viral causes. The measured specificities of the ELISA (98%) and the RecomBlot (97%) were comparable to those given by the manufacturer for IgM but were significantly lower for IgG (93% by ELISA and 66% by immunoblotting, versus reported values of 98% for ELISA and 95% for blotting). Antibody levels detected following infections with genotype 3 were lower than those following genotype 1 infections except for those measured in the IgM ELISA. Reactivity to the four antigens used in the immunoblot assay were analyzed and showed differences in the IgM immunoblot reactions between genotype 1 patients and genotype 3 patients. The ORF3 antigen was the most specific antigen. The specificity could be improved by a combined testing regimen with confirmation by immunoblotting of all positive ELISA results and by raising the cutoff of the IgG immunoblot assay without loss of sensitivity. We conclude that a combination of ELISA and immunoblotting is needed for acceptable specificity and sensitivity of HEV assays under conditions of low endemicity.Hepatitis E is an acute self-limiting disease that is common in Asia and Africa and considered emerging in many industrialized countries. After the discovery of the hepatitis E virus (HEV) by electron microscopy in 1983 and its subsequent characterization (2), HEV infections have been reported over a wide geographic area in Asia, Africa, the Middle East, and Central America (1). The lineages that are endemic in these regions differ antigenically and genetically and have been labeled Birma-like (genotype 1), Mexico-like (genotype 2), and China-like (genotype 4). In addition, besides travel-associated HEV infections, several reports have now shown indigenous circulation of a fourth lineage of HEV (genotype 3), both in humans and in swine in regions of the world previously considered free from HEV (3,8,10,(13)(14)(15)(16)(17).HEV infections are recognized in The Netherlands as an imported disease related to travel to regions of endemicity but also as a result of indigenous transmission of HEV. In the travel-related cases, genotype 1 is frequently detected, whereas most locally acquired HEV cases are caused by genotype 3 viruses. In view of the increasing awareness of the occurrence of HEV in regions with a temperate climate, it is important to validate the currently used serological assays for diagnosis o...

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Section: Discussionsupporting

confidence: 92%

Use of Serological Assays for Diagnosis of Hepatitis E Virus Genotype 1 and 3 Infections in a Setting of Low Endemicity

Herremans

Bakker

Duizer

et al. 2007

Clin Vaccine Immunol

106

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“…The other protein, MPII, is composed of strong and broad immunoreactive antigenic epitopes, some of which (ORF3 epitopes) are derived from two different HEV genotypes: the Mexico and Burma HEV strains (Khudyakov et al 1993(Khudyakov et al , 1994. It was shown that the combination of these two antigens can be used as a very efficient diagnostic target suitable for the reliable detection of HEV-specific antibodies in different epidemiological settings (Obriadina et al 2002).…”

Section: Discussionmentioning

confidence: 99%

“…Detection of IgG anti-HEV -Serum samples were tested for IgG anti-HEV by EIA according to the method described previously and standardized by Obriadina et al (2002) that uses two HEV recombinant proteins, a mosaic protein (MP-II) and a protein containing region 452-617 aa of the ORF2 of the HEV Burma strain as coating antigens. When applied to detection of HEV antibodies in animal sera, this EIA protocol was modified by using species-specific anti-IgG horseseradish peroxidase enzyme conjugates (anti-IgG-HRP, Sigma Chemicals St. Louis, MO) for serum samples representing respective species.…”

Section: Methodsmentioning

confidence: 99%

Serological evidence of hepatitis E virus infection in different animal species from the Southeast of Brazil

Vitral

Pinto

Lewis-Ximenez

et al. 2005

Mem. Inst. Oswaldo Cruz

124

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“…These assays have varied significantly (16), and assays based on open reading frame 2 (ORF2) were shown to be more sensitive in detecting anti-HEV than those based on ORF3 (1,11,17). These recombinant-protein-based tests have detected anti-HEV in 90 to 95% of symptomatic HEV cases (3,10…”

mentioning

confidence: 99%

Evaluation of Diagnostic Assays for Hepatitis E Virus in Outbreak Settings

et al. 2006

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Hepatitis E virus (HEV) is a major cause of hepatitis. We evaluated five HEV antibody diagnostic assays by using outbreak specimens. The Abbott immunoglobulin G (IgG), Genelabs IgG, and Walter Reed Army Institute of Research (WRAIR) IgM assays were about 90% sensitive; the Abbott IgG and WRAIR total Ig and IgM assays were more than 90% specific.Hepatitis E virus (HEV) is the principal cause of acute hepatitis on the Indian subcontinent, in southeastern and central Asia, in the Middle East, in Mexico, and in parts of Africa. It is associated with the consumption of fecally contaminated drinking water (7,8,12,15). Recent outbreaks have occurred in Iraq, Chad, Sudan, and India (2, 9). Although HEV is associated with a low case fatality rate in the general population, pregnant women in the second and third trimesters are at greater risk (case fatality rates of 10 to 24%) for fulminant hepatitis and fetal loss (14, 18).HEV has not been cultured in vitro, and most enzyme immunoassays (EIAs) for HEV infection are based on either recombinant HEV proteins or synthetic peptides. These assays have varied significantly (16), and assays based on open reading frame 2 (ORF2) were shown to be more sensitive in detecting anti-HEV than those based on ORF3 (1,11,17). These recombinant-protein-based tests have detected anti-HEV in 90 to 95% of symptomatic HEV cases (3,10

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A new enzyme immunoassay for the detection of antibody to hepatitis E virus

Abstract: The new HEV EIA developed in the present study is a highly specific diagnostic assay for the detection of anti-HEV activity in serum specimens obtained from different epidemiologic settings.

Cited by 29 publications

References 30 publications

Use of Serological Assays for Diagnosis of Hepatitis E Virus Genotype 1 and 3 Infections in a Setting of Low Endemicity

Use of Serological Assays for Diagnosis of Hepatitis E Virus Genotype 1 and 3 Infections in a Setting of Low Endemicity

Serological evidence of hepatitis E virus infection in different animal species from the Southeast of Brazil

Evaluation of Diagnostic Assays for Hepatitis E Virus in Outbreak Settings

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