Consecutive evaluation of immunoglobulin M and G antibodies against hepatitis E virus

Abstract

Hepatitis E virus (HEV) infection is sporadic in the Guangzhou city southern China. However, the evaluation of antibodies to HEV during consecutive time periods after infection has not been reported. We utilized enzyme immunosorbent assay (ELISA) to defect IgM and IgG anti-HEV in consecutive serum specimens from patients with acute hepatitis E and compared that data with detection rates of IgM and IgG anti-HAV in patients with acute hepatitis A. IgM anti-HEV can be detected as early as 4 days after onset of disease symptoms in some patients. The detection rate of IgM anti-HEV is significantly higher in specimens collected within 4 weeks (95%) of onset than in those specimens collected 4 to 18 weeks after onset (67.6%) (P < 0.005). IgM anti-HEV had a similar pattern to IgM anti-HAV and can be used as a marker of acute HEV infection. In contrast with IgG anti-HAV, 56.8% of the specimens did not contain detectable levels of IgG anti-HEV (P < 0.005). One should be cautioned against making a diagnosis of HEV infection solely by the currently available assays for IgG anti-HEV. In conclusion, IgM anti-HEV can be used as a reliable and sensitive marker for recent HEV infection, but serum specimens should be collected within 4 weeks after onset of symptoms to avoid false-negative results. In contrast, we should be aware of the failure to develop IgG anti-HEV in some patients. These patients carry the risk of reinfection.

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

“…The sensitivity of IgG was also poor in our study. This could be attributable to the failure to develop IgG anti‐HEV in some patients (Ke et al , 1996), or to the delay in the appearance of anti‐HEV IgG; however, it was speculated that it may be detected as early as 2 days after onset of the disease, with a cumulative positive seroconversion rate of 100% by 1 month. Moreover, the lack of association of HEV seropositivity with a history of liver disease or viral hepatitis is consistent with the absence of outbreaks, and suggests that most infections occurred early in life and were asymptomatic or caused only mild illness (Fix et al , 2000).…”

Hepatitis E virus (HEV) infection in patients with cirrhosis is associated with rapid decompensation and death

“…In contrast, the prevalence of IgG anti-HEV antibody among adults in these region varies from 17.5% to 56% [11][12][13]. Protective role of IgG-anti-HEV is unclear and repeated HEV infection in an individual have been documented [14,15]. Therefore, in hyperendemic areas of HAV and HEV, while large immune population against HAV exist, the adult population remain susceptible to HEV infection, as documented during multiple epidemics of HEV in Asia and Africa [1,2].…”

Anti-VHE IgM en casos de infección por el virus hepatitis E

“…Por ello, se recomienda su detección dentro de las primeras cuatro semanas de iniciados los síntomas [7][8][9] .…”

“…Por lo anterior, en la práctica clínica sólo se investiga el anti-VHE IgG, por ser este marcador de aparición precoz y mantenido en el tiempo 7,8 .…”