No abstract

Globally, most HBV-related deaths result from the chronic sequelae of infection acquired in the perinatal and early childhood periods. Inclusion of hepatitis B vaccine into national infant immunization programs could prevent >80% of HBV-related deaths.

If duration of membrane rupture and internal fetal monitoring are confirmed to be associated with transmission, interventions may be possible to decrease the risk of transmission.

No abstract

Few data are available to evaluate the performance of existing assays for antibody to the hepatitis E virus (anti-HEV). A panel of 164 randomized and coded sera was tested for anti-HEV by 12 different assays. The panel included a dilution series of an early convalescent human serum, known-positive sera (undiluted human sera obtained 2 months to 13 years after acute hepatitis E, and postinoculation chimpanzee sera), known-negative sera (preinoculation chimpanzee sera; sera from chimpanzees with hepatitis A virus, hepatitis B virus, or hepatitis C virus infection; and normal human sera), and sera obtained from previously tested U.S. blood donors without a history of hepatitis. Six tests detected anti-HEV in H90% of undiluted knownpositive sera. The sensitivity of all of the assays with known-positive sera ranged from 17% to 100%, and the limit of detection by endpoint dilution ranged from 1:5 to 1:160. Ten tests were nonreactive for all of the 22 knownnegative sera, one test was reactive for one serum, and one test was reactive for 5 sera. In pairwise comparisons of different tests in blood donor sera, the overall concordance ranged from 49% to 94% (median, 69%) and the concordance among reactive sera ranged from 0% to 89% (median, 32%). Several of these tests performed well in detecting anti-HEV in known positive sera. However, highly discrepant results among U.S. blood donor sera indicate that anti-HEV seroprevalence data in non-HEV-endemic countries may be unreliable and should be interpreted with caution. (HEPATOLOGY 1998;27:857-861.)The performance of tests for antibody to the hepatitis E virus (anti-HEV) is an important factor in assessing the epidemiology of hepatitis E virus (HEV) infection. The first serologic assays for anti-HEV included immune electron microscopy 1,2 and a fluorescent antibody blocking assay, 3,4 both of which utilize native HEV antigen as a target for detection. Although these assays are specific, they have limited sensitivity: anti-HEV has been detected in only 50% to 70% of patients with acute hepatitis during hepatitis E outbreaks, and anti-HEV titers decline to subdetectable levels within several months after acute infection. After HEV was cloned and sequenced, a variety of tests, including both Western blot assays and enzyme immunoassays (EIAs), were developed to detect anti-HEV by using recombinantexpressed proteins or synthetic peptides that model immunodominant epitopes of the putative structural regions of HEV [open reading frames (ORFs) 2 and 3]. [5][6][7][8][9][10][11][12][13][14][15][16] Several recombinant protein-based tests have demonstrated increased sensitivity compared to prior assays, detecting anti-HEV in 90% to 95% of patients with acute hepatitis during outbreaks of hepatitis E in HEV-endemic areas. 6,17 Recently, a number of cases of acute hepatitis E, diagnosed on the basis of serologic testing, have been reported among persons who had no history of travel to HEV-endemic areas. [18][19][20][21][22][23] However, the interpretation of these findings is problematic...