Detection of IgA class antibody to hepatitis E virus in serum samples from patients with hepatitis E virus infection

Chau, Kurt H.; Dawson, George J.; Bile, Khalif; Magnius, Lars O.; Sjögren, Maria H.; Mushahwar, Isa K.

doi:10.1002/jmv.1890400414

Cited by 58 publications

(27 citation statements)

References 21 publications

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“…Therefore, in the present study, we chose the solid-phase ELISA format for detecting anti-HEV antibodies. It has been reported that anti-HEV IgA can be utilized as an additional confirmatory antibody for recent HEV infection (2). Although the presence of a specific antibody of the IgA class is diagnostic for recent infection in several viral or nonviral diseases, including type A, type B, or type C acute hepatitis (28,35,57), as well as Chlamydia trachomatis infection, Chlamydia pneumoniae infection, and cholera (26,33,51), the clinical and epidemiological significance of positivity for anti-HEV IgA remains to be fully verified.…”

Section: Discussionmentioning

confidence: 99%

“…The immunoglobulin M (IgM) class of antibody against HEV (anti-HEV IgM) is used as a reliable and sensitive marker of recent HEV infection (2)(3)(4)38). However, the specificity of the solid-phase assay for anti-HEV IgM has been questioned in some cases, particularly in patients with IgMrheumatoid factors in the serum, which have activity against the Fc portion of IgG directed to HEV antigen and may elicit a false-positive result (10).…”

mentioning

confidence: 99%

“…Virus-specific IgA class antibodies have been detected during the acute stage of infection with hepatitis A virus (HAV) (57) or hepatitis B virus (HBV) (28). The IgA class of antibodies has also been detected in sera from patients with hepatitis E (2,14,47). Although a few previous studies reported that anti-HEV IgA could be utilized as an additional confirmatory antibody for recent HEV infection (2,47), the clinical and epidemiological implications of positivity for anti-HEV IgA remain to be clarified.…”

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confidence: 99%

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Simultaneous Detection of Immunoglobulin A (IgA) and IgM Antibodies against Hepatitis E Virus (HEV) Is Highly Specific for Diagnosis of Acute HEV Infection

et al. 2005

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Hepatitis E, the major form of enterically transmitted non-A, non-B hepatitis, is caused by hepatitis E virus (HEV). HEV is transmitted primarily by the fecal-oral route. Waterborne epidemics are characteristic of hepatitis E in developing regions of Africa, the Middle East, and Southeast and Central Asia, where sanitation conditions are suboptimal; one epidemic has also been documented in North America (Mexico) (32). HEV-associated hepatitis also occurs among individuals in industrialized countries with no history of travel to areas where HEV is endemic (6,9,18,25,36,37,39,41,52,54). Recently, accumulating lines of evidence indicate that hepatitis E is a zoonosis, and pigs or other animals may act as reservoirs for HEV infection in humans (9, 15, 20-24, 27, 39, 42, 45, 56). A significant proportion of healthy individuals in industrialized countries where hepatitis E is not endemic are seropositive for HEV antibodies (8,19,46). Therefore, several epidemiological questions remain unanswered. The success of future studies on clinical and subclinical HEV infection not only in developing countries but also in industrialized countries will greatly depend on the availability of assays that are sensitive and specific.HEV was recently classified as the sole member of the genus Hepevirus in the family Hepeviridae. The genome of HEV is a 7.2-kb, positive-sense, single-stranded RNA. It contains a short 5Ј untranslated region, three open reading frames (ORFs; ORF1, ORF2 and ORF3), and a short 3Ј untranslated region terminated by a poly(A) tract (12,34,44,53). ORF1 encodes nonstructural proteins, ORF2 encodes the capsid protein, and ORF3 encodes a cytoskeleton-associated phosphoprotein. Extensive diversity has been noted among HEV isolates, and HEV sequences have been classified into four major genotypes (genotypes 1 to 4) (37). In Japan, polyphyletic HEV strains of genotype 3 or 4 or both have been isolated from patients with sporadic acute or fulminant hepatitis E who had no history of travel to countries where this virus is endemic (1,25,30,40,41,56).The immunoglobulin M (IgM) class of antibody against HEV (anti-HEV IgM) is used as a reliable and sensitive marker of recent HEV infection (2-4, 38). However, the specificity of the solid-phase assay for anti-HEV IgM has been questioned in some cases, particularly in patients with IgMrheumatoid factors in the serum, which have activity against the Fc portion of IgG directed to HEV antigen and may elicit

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Simultaneous Detection of Immunoglobulin A (IgA) and IgM Antibodies against Hepatitis E Virus (HEV) Is Highly Specific for Diagnosis of Acute HEV Infection

et al. 2005

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“…At least 50% of cases of sporadic hepatitis admitted to military hospitals in Rawalpindi, Pakistan, are non-A, non-B hepatitis (presumably hepatitis E). [25][26][27][28] In 1993−1994, a large outbreak of hepatitis E occurred in Islamabad, the capital of Pakistan, as a result of contamination from a malfunctioning water treatment plant. Almost 4,000 cases were reported 20 .…”

Section: Discussionmentioning

confidence: 99%

Epidemic of hepatitis E in a military unit in Abbotrabad, Pakistan.

Bryan¹,

Iqbal²,

Tsarev³

et al. 2002

The American Journal of Tropical Medicine and Hygiene

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Abstract. An outbreak of hepatitis caused by hepatitis E virus (HEV) in Abbottabad, Pakistan was traced to fecal contamination of a water system. Of 109 men hospitalized with hepatitis, 104 (95%) had serologic evidence of acute hepatitis E (IgM antibody to HEV [anti-HEV]), three (3%) probably had acute hepatitis E (high titers of IgG anti-HEV without IgM), and two had acute hepatitis A. Among a subset of 44 men with acute hepatitis E from whom three serum specimens were obtained over a four-month period, the anti-HEV IgG geometric mean titers (GMTs) decreased from 1,519 during the outbreak to 657 at four months. The IgM anti-HEV was detected in 40 (91%) of 44 sera obtained at admission (GMT ‫ס‬ 533 during acute disease), but in only six (14%) four months later. The prevalence of anti-HEV in this population before the outbreak was estimated to be 30%. The presence of IgG anti-HEV appeared to protect against clinical hepatitis or development of serologic evidence of new infection with HEV. This is the second major epidemic of hepatitis E in the Pakistani military confirmed by an anti-HEV enzyme-linked immunosorbent assay (ELISA). Evidence that pre-existing antibody as measured by this ELISA protects against disease is important for assessment of vaccine development.

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“…As for anti-HEV IgA antibodies, it is unclear whether our assay is detecting both dimeric secretory IgA and monomeric IgA. However, it seems that anti-HEV IgA antibodies can be utilized as an additional confirmatory antibody for recent HEV infection, as suggested by Chau et al (1993) who detected anti-HEV IgA antibodies in serum samples obtained from patients who had acute waterborne hepatitis in southern Somalia and Pakistan.…”

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confidence: 94%

Molecular and serological characterization of sporadic acute hepatitis E in a Japanese patient infected with a genotype III hepatitis E virus in 1993

Tokita

Harada

Gotanda

et al. 2003

Journal of General Virology

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Serum samples collected periodically from a 40-year-old Japanese woman who had not travelled abroad and who had contracted sporadic acute hepatitis E in 1993 were semi-quantitatively tested by enzyme immunoassay for IgM, IgA and IgG antibodies to hepatitis E virus (HEV). Anti-HEV IgM and IgA antibody levels were the highest (1 : 2400 dilution and 1 : 3400 dilution, respectively) on day 9 after the onset of hepatitis and then decreased rapidly in a parallel manner. Anti-HEV IgG antibody levels were the highest (1 : 17000 dilution) on day 145 and then decreased gradually but remained at high titres (1 : 2200 dilution) even 8?7 years after the onset of hepatitis. An HEV isolate, HE-JA10, recovered from the patient's serum at admission was closely related to a genotype III strain isolated in the United States (US1), with 92?2% identity over the full-length genome, and was most closely related to the JMY-Haw isolate of Japanese origin (95?4% identity).Hepatitis E virus (HEV) is a major cause of epidemic and sporadic, enterically transmitted non-A, non-B hepatitis in many developing countries in Asia, Africa and Latin America (Purcell & Emerson, 2001a). Recently, there is growing consensus that (i) HEV-associated hepatitis also occurs among individuals in industrialized countries with no history of travel to areas endemic for HEV (Harrison, 1999;Purcell & Emerson, 2001a;Schlauder & Mushahwar, 2001) and (ii) HEV is a zoonotic virus, as suggested by the close genetic relationship between human and swine viruses (Erker et al., 1999; Hsieh et al., 1999;Meng et al., 1997Meng et al., , 1998. The genome of HEV is a single-stranded, positivesense RNA of approximately 7?2 kb and contains a short 59 untranslated region (UTR), three open reading frames (ORFs 1-3) and a short 39 UTR terminated by a poly(A) tract (Reyes et al., 1990;Tam et al., 1991). HEV sequences have been classified tentatively into four major genetic groups (genotypes I-IV) (Schlauder & Mushahwar, 2001). Worldwide, the majority of HEV infections are caused by genotype I, while only isolated cases of infection with HEV of genotype III or IV have been described in the United States, Europe, Argentina, Taiwan and China (Hsieh et al., 1999; Kwo et al., 1997;Pina et al., 2000;Schlauder et al., 1998Schlauder et al., , 1999Schlauder et al., , 2000Wang et al., 1999Wang et al., , 2000Wang et al., , 2001Worm et al., 2000;Zanetti et al., 1999). In Japan, multiple HEV strains of genotype III or IV have been isolated from patients with acute hepatitis of non-ABC aetiology who had never been abroad (Takahashi et al., , 2002aMizuo et al., 2002), and swine HEV strains of genotype III have been isolated from farm pigs in Japan (Okamoto et al., 2001). These results indicate that heterogeneous HEV strains are circulating in Japan and that domestically infected hepatitis E occurs in Japan, where HEV infection had been considered to be non-endemic. However, the molecular and serological characteristics of sporadic acute hepatitis E in industrialized countries, including Japan, a...

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Detection of IgA class antibody to hepatitis E virus in serum samples from patients with hepatitis E virus infection

Cited by 58 publications

References 21 publications

Simultaneous Detection of Immunoglobulin A (IgA) and IgM Antibodies against Hepatitis E Virus (HEV) Is Highly Specific for Diagnosis of Acute HEV Infection

Simultaneous Detection of Immunoglobulin A (IgA) and IgM Antibodies against Hepatitis E Virus (HEV) Is Highly Specific for Diagnosis of Acute HEV Infection

Epidemic of hepatitis E in a military unit in Abbotrabad, Pakistan.

Molecular and serological characterization of sporadic acute hepatitis E in a Japanese patient infected with a genotype III hepatitis E virus in 1993

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