Acute sporadic hepatitis E in children: diagnostic relevance of specific immunoglobulin M and immunoglobulin G compared with nested reverse transcriptase PCR

Zaki, Maysaa El Sayed; Zaghloul, Hosam; Sayed, Othman El

doi:10.1111/j.1574-695x.2006.00111.x

Cited by 27 publications

(8 citation statements)

References 35 publications

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“…The results obtained here for IgM were higher than those reported by another study by Zaki et al (2006). This can be attributed to variations in the population studied and the period of the study.…”

Section: Discussioncontrasting

confidence: 85%

Value of hepatitis E virus detection by cell culture compared with nested PCR and serological studies by IgM and IgG

Zaki¹,

Foud²,

Mohamed³

2009

FEMS Immunology &Amp; Medical Microbiology

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Hepatitis E virus (HEV) is a well-known cause of sporadic acute hepatitis. The contribution of fecal shedding of the virus to its endemic nature is not frequently studied in underdeveloped countries. The aim of the present study was to detect HEV viremia in serum and stool from patients with acute hepatitis by cell culture and by nested reverse transcriptase (RT)-PCR. A further aim was to evaluate different methods used for HEV detection, including culture by use of HPG11 cell line, PCR, immunoglobulin M (IgM) and IgG responses during the acute stage of infection. The frequency of HEV-positive cases for IgM, stool and serum cultures was 35.3%, 38.2% and 29.4%, respectively. However, only two samples (2.9%) were positive for IgG using enzyme immunoassay. The sensitivity of stool culture was 41.9%, the sensitivity of both HEV IgM and the combined laboratory tests was 37.5% for each, the sensitivity of serum culture was 30.3% and the sensitivity for HEV IgG was 2.3%. We conclude that hepatitis E viremia can be detected both in serum and in stool from patients with acute hepatitis. The shedding of virus in the stool of patients may be the responsible factor for the endemicity of HEV. In addition, the detection of HEV had high sensitivity compared with other methods. Nevertheless, it was necessary to use both stool and serum cultures to avoid missing any case with HEV infection.

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Section: Discussioncontrasting

confidence: 85%

Value of hepatitis E virus detection by cell culture compared with nested PCR and serological studies by IgM and IgG

Zaki¹,

Foud²,

Mohamed³

2009

FEMS Immunology &Amp; Medical Microbiology

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“…Third, studies use different criteria to define acute hepatitis. In a study of Egyptian children, acute hepatitis was defined as the acute injury to the liver, manifested by two fold or more increase in the level of aspartate aminotransferase and alanine aminotransferase [47] whereas in another study, acute hepatitis was defined as the patient whose aminotransferase level was 5 times the normal value [133]. Finally, different surveillance methods may lead to different attack rates being determined.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of the epidemiology of hepatitis E virus in Africa

et al. 2014

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BackgroundHepatitis E Virus (HEV) infection is a newly recognized serious threat to global public health and Africa is suspected to be among the most severely affected regions in the world. Understanding HEV epidemiology in Africa will expedite the implementation of evidence-based control policies aimed at preventing the spread of HEV including policies for the use of available resources such as HEV vaccines.MethodsHere we present a comprehensive review of HEV epidemiology in Africa based on published data. We searched for articles on HEV epidemiology in Africa from online databases such as PubMed, Scopus, and ISI Web of Science and critically reviewed appropriate publications to extract consistent findings, identify knowledge gaps, and suggest future studies.ResultsTaking a particularly high toll in pregnant women and their fetuses, HEV has infected human populations in 28 of 56 African countries. Since 1979, 17 HEV outbreaks have been reported about once every other year from Africa causing a reported 35,300 cases with 650 deaths.ConclusionsIn Africa, HEV infection is not new, is widespread, and the number of reported outbreaks are likely a significant underestimate. The authors suggest that this is a continent-wide public health problem that deserves the attention of local, regional and international agencies to implement control policies that can save numerous lives, especially those of pregnant women and their fetuses.

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“…3,34,35 In studies of acute hepatitis in which patients were tested at or near the onset of illness, serum HEV-RNA was detected in only 50-66% of anti-HEV IgM positive cases. 30,36 HEV RNA is also detectable in stool during the acute phase of infection, although the reliability of testing stool versus serum has not been adequately evaluated.…”

Section: Discussionmentioning

confidence: 99%

Acute Hepatitis E Infection Accounts for Some Cases of Suspected Drug-Induced Liver Injury

et al. 2011

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Background & Aims The diagnosis of drug-induced liver injury relies upon exclusion of other causes, including viral hepatitis A, B, and C. Hepatitis E virus (HEV) infection has been proposed as another cause of suspected drug-induced liver disease. We assessed the frequency of HEV infection among patients with drug-induced liver injury in the United States. Methods The drug-induced liver injury network (DILIN) is a prospective study of patients with suspected drug-induced liver injury; clinical information and biological samples are collected to investigate pathogenesis and disease progression. We analyzed serum samples, collected from patients enrolled in DILIN, for immunoglobulin (Ig)G and IgM against HEV; selected samples were tested for HEV RNA. Results Among 318 patients with suspected drug-induced liver injury, 50 (16%) tested positive for anti-HEV IgG and 9 (3%) for anti-HEV IgM. The samples that contained anti-HEV IgM (collected 2 to 24 weeks after onset of symptoms) included 4 that tested positive for HEV RNA, genotype 3. Samples from the 6-month follow-up visit were available from 4 patients; they were negative for anti-HEV IgM, but levels of anti-HEV IgG increased with time. Patients that had anti-HEV IgM were mostly from older men (89%; mean age, 67 years) and 2 were HIV positive. Clinical reassessment of the 9 patients with anti-HEV IgM indicated that acute hepatitis E was the most likely diagnosis for 7 and might be the primary diagnosis for 2. Conclusion HEV infection contributes to a small but important proportion of cases of acute liver injury that are suspected of being drug induced. Serologic testing for HEV infection should be performed—particularly if clinical features are compatible with acute viral hepatitis.

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Acute sporadic hepatitis E in children: diagnostic relevance of specific immunoglobulin M and immunoglobulin G compared with nested reverse transcriptase PCR

Cited by 27 publications

References 35 publications

Value of hepatitis E virus detection by cell culture compared with nested PCR and serological studies by IgM and IgG

Value of hepatitis E virus detection by cell culture compared with nested PCR and serological studies by IgM and IgG

A systematic review of the epidemiology of hepatitis E virus in Africa

Acute Hepatitis E Infection Accounts for Some Cases of Suspected Drug-Induced Liver Injury

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