Active Surveillance for Acute Viral Hepatitis in Rural Villages in the Nile Delta

Meky, Fatma A.; Stoszek, Sonia K.; Hamid, Mohamed Abdel; Selim, Sahar; Wahab, Ayman Abdel; Mikhail, Nabiel; El-Kafrawy, Sherif A.; El-Daly, Maï; Abdel-Aziz, Fatma; Sharaf, Soraya; Mostafa, Mohamed; Engle, Ronald E.; Emerson, Suzanne U.; Purcell, Robert H.; Fix, Alan; Strickland, G. Thomas

doi:10.1086/500133

Cited by 56 publications

(55 citation statements)

References 23 publications

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“…However, HEV-caused AVH is very rare in the US. A similar situation exists in Egypt where up to 80% of the inhabitants of rural villages have anti-HEV with very little or no evidence that the infection causes acute hepatitis in the subjects in these community-based studies (Fix et al, 2000;Meky et al, 2006;, although, just as in the US, sporadic cases of acute hepatitis E infections are reported (Zakaria et al, 2007). The reasons for this discrepancy are unclear.…”

Section: Introductionmentioning

confidence: 84%

Characterization of hepatitis E-specific cell-mediated immune response using IFN-γ ELISPOT assay

Shata

Barrett

Shire

et al. 2007

Journal of Immunological Methods

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In developing countries, hepatitis E (HEV) and hepatitis A (HAV) are the major causes of acute viral hepatitis with similar fecooral modes of transmission. In contrast to the high seroprevalence of hepatitis A infection, a low seroprevalence of HEV among children in endemic areas has been reported. These data suggest the possibility that silent HEV infection is undiagnosed by the current available methods. Many of the serological tests used for HEV diagnosis have poor specificity and are unable to differentiate among different genotypes of HEV. Moreover, the RT-PCR used for HEV isolation is only valid for a brief period during the acute stage of infection. Cell-mediated immune (CMI) responses are highly sensitive, and long lasting after sub-clinical infections as shown in HCV and HIV. Our objective was to develop a quantitative assay for cell-mediated immune (CMI) responses in HEV infection as a surrogate marker for HEV exposure in silent infection. Quantitative assessment of the CMI responses in HEV will also help us to evaluate the role of CMI in HEV morbidity. In this study, an HEV-specific interferon-gamma (IFN-γ) ELISPOT assay was optimized to analyze HEV-specific CMI responses. We used peripheral blood mononuclear cells (PBMC) and sera from experimentally infected chimpanzees and from seroconverted and control human subjects to validate the assay. The HEV-specific IFN-γ ELISPOT responses correlated strongly and significantly with anti-HEV ELISA positive/negative results (rho=0.73, p=0.02). Moreover, fine specificities of HEV-specific T cell responses could be identified using overlapping HEV ORF2 peptides.

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Section: Introductionmentioning

confidence: 84%

Characterization of hepatitis E-specific cell-mediated immune response using IFN-γ ELISPOT assay

Shata

Barrett

Shire

et al. 2007

Journal of Immunological Methods

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“…The kit uses HCV-specific primers and probes as well as internal controls. HBV surface antigen (HBsAg) (Murex) and anti-HBs (Adaltis, Italy) EIAs were performed according to the manufacturer's instructions and as previously described (2,35). Detection of Schistosoma mansonispecific IgG was performed by EIA according to the manufacturer's instructions (Novatec Immunodiagnostica GmbH, Germany).…”

Section: Methodsmentioning

confidence: 99%

Hepatitis C Virus-Multispecific T-Cell Responses without Viremia or Seroconversion among Egyptian Health Care Workers at High Risk of Infection

Abdelwahab¹,

Zakaria²,

Sobhy³

et al. 2012

Clin. Vaccine Immunol.

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001). Flow cytometry indicated that both CD4؉ and CD4 ؊ T cells produced IFN-␥. In summary, more than half of Egyptian HCW demonstrated strong HCV multispecific CMI without viremia or seroconversion, suggesting possible clearance of low HCV exposure(s). These data suggest that detecting anti-HCV and viremia to determine past exposure to HCV can lead to an underestimation of the true disease exposure and that CMI response may contribute to the low degree of chronic HCV infection in these HCW. These findings could have strong implications for planning vaccine studies among populations with a high HCV exposure rate. Further studies are needed to determine whether these responses are protective.

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“…The different patterns of illness seen among pregnant women, paralleling regional differences in agespecific attack rates and seroprevalence (34,159,160), remain perplexing (Table 1). The study of this range of possible outcomes of HEV infection is challenging, given that most HEV research occurs either in acute-outbreak settings or in clinical contexts where only severely ill patients are typically referred.…”

Section: Epidemiologic Patterns Of Hepatitis E Virus Infectionmentioning

confidence: 99%

Host Immune Status and Response to Hepatitis E Virus Infection

2014

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SUMMARY Hepatitis E virus (HEV), identified over 30 years ago, remains a serious threat to life, health, and productivity in developing countries where access to clean water is limited. Recognition that HEV also circulates as a zoonotic and food-borne pathogen in developed countries is more recent. Even without treatment, most cases of HEV-related acute viral hepatitis (with or without jaundice) resolve within 1 to 2 months. However, HEV sometimes leads to acute liver failure, chronic infection, or extrahepatic symptoms. The mechanisms of pathogenesis appear to be substantially immune mediated. This review covers the epidemiology of HEV infection worldwide, the humoral and cellular immune responses to HEV, and the persistence and protection of antibodies produced in response to both natural infection and vaccines. We focus on the contributions of altered immune states (associated with pregnancy, human immunodeficiency virus [HIV], and immunosuppressive agents used in cancer and transplant medicine) to the elevated risks of chronic infection (in immunosuppressed/immunocompromised patients) and acute liver failure and mortality (among pregnant women). We conclude by discussing outstanding questions about the immune response to HEV and interactions with hormones and comorbid conditions. These questions take on heightened importance now that a vaccine is available.

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Active Surveillance for Acute Viral Hepatitis in Rural Villages in the Nile Delta

Cited by 56 publications

References 23 publications

Characterization of hepatitis E-specific cell-mediated immune response using IFN-γ ELISPOT assay

Characterization of hepatitis E-specific cell-mediated immune response using IFN-γ ELISPOT assay

Hepatitis C Virus-Multispecific T-Cell Responses without Viremia or Seroconversion among Egyptian Health Care Workers at High Risk of Infection

Host Immune Status and Response to Hepatitis E Virus Infection

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