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

Herremans, Marc; Bakker, J.; Duizer, Erwin; Vennema, Harry; Koopmans, Marion

doi:10.1128/cvi.00231-06

Cited by 106 publications

(89 citation statements)

References 18 publications

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“…A serological study showed IgM antibodies to hepatitis E (two assays were used: HEV IgM ELISA by Genelabs, with a sensitivity of 93% and a specificity of 99%; and Recomblot HEV IgM by Mikrogen, with a sensitivity of 85.7% and a specificity of 100% in non endemic regions [5] ). Hepatitis B surface antigen, antibodies to hepatitis C, IgM anti-HAV were absent.…”

Section: Case Reportmentioning

confidence: 99%

Guillain-Barré syndrome following hepatitis E

Loly¹,

Rikir²,

Seivert³

et al. 2009

WJG

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Guillain-Barré syndrome (GBS) is often triggered by a preceding bacterial or viral infection. Occasionally, it has been observed in association with acute hepatitis A, B and C, and three cases have been previously described in India in which GBS was associated with acute hepatitis E. A molecular mimicry mechanism is supposed to be involved in the pathogenesis of GBS triggered by infectious agents, although the nature of the shared epitopes has not been characterized in most instances, including that in the case of hepatotropic viruses. We report a case of GBS following acute hepatitis E in a European individual. The presence of antiganglioside GM2 antibodies in this patient suggested molecular mimicry involving ganglioside GM2 in the pathogenesis of GBS associated with hepatitis E.

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Section: Case Reportmentioning

confidence: 99%

Guillain-Barré syndrome following hepatitis E

Loly¹,

Rikir²,

Seivert³

et al. 2009

WJG

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“…Various reports indicate that commercial assays sometimes fail to detect specific antibodies in sera from patients with proven HEV genotype 3 infections, and thus the number of autochthonous HEV infections in industrialized regions may have been underestimated [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of hepatitis E virus (HEV) antibodies in Serbian blood donors

Lupulović

Oya

Vojvodic³

et al. 2014

J Infect Dev Ctries

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Introduction: Hepatitis E virus (HEV) infection is rarely reported in industrialized countries, but recent studies have revealed quite variable seroprevalence rates among European populations, including blood donors. In Serbia, very limited data about HEV seroprevalence are available. This study aimed to determine the prevalence of anti-HEV IgG antibodies and HEV RNA in the sera of volunteer blood donors in Serbia. Methodology: Serum samples from 200 volunteer blood donors were tested for the presence of anti-HEV IgG by enzyme-linked immunosorbent assay (ELISA) using ORF-2 HEV genotype 3 recombinant proteins as antigen, and for the presence of HEV RNA by nested reverse transcriptase polymerase chain reaction (RT-PCR). Results: In total, 15% of the volunteer blood donors were seropositive. The prevalence increased with age; 21.5%, 14.2%, and 5.4% HEV seroprevalence rates were found in individuals older than 51 years, between 31 and 50 years, and in those younger than 30 years of age, respectively. However, no HEV RNA was detected in any of the individuals analyzed. Conclusions: The prevalence of anti-HEV IgG among blood donors as representatives of the general population is quite high in Serbia compared to data from many European countries. One of the reasons for this could be the high prevalence of HEV among Serbian pigs and the traditional consumption of piglet meat in the country. The relatively high HEV seroprevalence found among Serbian blood donors indicates the need for further investigation.

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“…Cross-reactions among viral hepatitis antibodies have been reported previously. 20 Finally, 1 patient had a result that was either a false positive or the consequence of a technical error; this conclusion is based on the simultaneous negative total HAV antibody and positive IgM antibody results in a more dilute sample. Simultaneous measurement of total antibody and IgM can be performed and may prove to be beneficial in helping physicians correctly interpret HAV serology.…”

Section: False-positive and Low-positive Resultsmentioning

confidence: 98%

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

Alatoom

Ansari

Cuthbert

2013

Archives of Pathology &Amp; Laboratory Medicine

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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 1 Since the introduction of a safe and effective vaccine and its widespread adoption, the actual number of cases has decreased to approximately 10% of the peak level.2 Of paramount importance, any bona fide new diagnosis of acute hepatitis A has public health implications. Cases are reported to the local health departments to identify a possible common source of infection and provide postexposure prophylaxis to contacts of the index patient.Testing for immunoglobulin (Ig) M antibodies against HAV (IgM anti-HAV) is the mainstay of the serologic diagnosis for acute hepatitis A infection and has been highly sensitive and specific.3-5 The presence of any detectable antibody (total anti-HAV) plus the absence of high-titer IgM-specific antibodies is used to differentiate between past and current infection. In the past few years, isolated reports have documented an increase in the number of positive results for IgM anti-HAV in patients whose illnesses were not consistent with the case definition of hepatitis A in conjunction with the decrease in true incidence. [6][7][8] We conducted a retrospective study to determine how commonly we may be encountering potential false-positive results after noticing the occurrence of positive IgM anti-HAV test results in the absence of clinical findings suggesting acute viral hepatitis. We explored possible underlying reasons and the effect of changing ordering options. MATERIALS AND METHODSAn institutional review board approved a retrospective medical record analysis for all patients with positive results for IgM anti-HAV antibodies between January 2007 and December 2010. Patients were identified by querying the laboratory information system (Cerner Millennium, Cerner Corporation, Kansas City, Missouri) to generate the list of samples and order type (individual test or group) associated with positive results. Results from internal and external quality control assessments were excluded. Data CollectionPatient demographics, clinical history, and laboratory data were obtained through review of electronic and paper medical records. Patient age, sex, and race/ethnicity were recorded for each patient. Laboratory data included test results for bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), all viral hepatitis serologic assays, rheumatoid factor, and human immunodeficiency virus antibody at the time of diagnosis. Test OrderingTest order information was obtained from the electronic medical record and from review of paper medical records. The ordering

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

Cited by 106 publications

References 18 publications

Guillain-Barré syndrome following hepatitis E

Guillain-Barré syndrome following hepatitis E

Prevalence of hepatitis E virus (HEV) antibodies in Serbian blood donors

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

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