Diagnostic utility of hepatitis E virus antigen-specific ELISA versus PCR testing in a cohort of post liver transplant patients in a large university hospital

Soothill, Germander; Hessey, Sonya; Erotocritou, Marios; Griffiths, Paul; Ijaz, Samreen; Thorburn, Douglas; Ankcorn, Mike; Irish, Dianne

doi:10.1016/j.jcv.2018.07.007

Cited by 7 publications

(21 citation statements)

References 21 publications

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“…A total of 113 patients with persistent HEV infection were identified between January 2009 and December 2017. Nineteen cases were excluded as they were identified through screening studies 19,24,25 …”

Section: Resultsmentioning

confidence: 99%

Persistent Hepatitis E virus infection across England and Wales 2009‐2017: Demography, virology and outcomes

Ankcorn

Said

Morgan

et al. 2020

Journal of Viral Hepatitis

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The first clinical case of persistent HEV infection in England was reported in 2009. We describe the demography, virology and outcomes of patients identified with persistent HEV infection in England and Wales between 2009 and 2017. A series of 94 patients with persistent HEV infection, defined by HEV viraemia of more than 12 weeks, was identified through routine reference laboratory testing. Virology, serology and clinical data were recorded through an approved PHE Enhanced Surveillance System. Sixty-six | 421 ANKCORN et Al.

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Section: Resultsmentioning

confidence: 99%

Persistent Hepatitis E virus infection across England and Wales 2009‐2017: Demography, virology and outcomes

Ankcorn

Said

Morgan

et al. 2020

Journal of Viral Hepatitis

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“…In addition, 27 studies 5,14,15,18,22,26–47 were evaluated for the second arm on HEV treatment, including 118 LT recipients (6 of them with dual liver/kidney and 1 with liver/heart recipients) treated with various regimens for HEV infection (Table 3).…”

Section: Resultsmentioning

confidence: 99%

“…The median age ranged from 42 to 63 years. Race characteristics were recorded only in one British study 18 : 66% were Caucasian, 18% Asian, 7% Black, 9% other. The percentage of male LT recipients in the cohorts ranged from 51.2% to 83.3% 9,10,13–19,21,23,24 .…”

Section: Resultsmentioning

confidence: 99%

“…At the time of evaluation (ranging from 3 to 107 months post‐LT) 9,10,15,16,19,21,23,24 the mean/median values of AST, ALT and bilirubin were from 24 to 59 IU/L, 10,15,16,24 19 to 71 IU/L 10,11,13,15,16,24 and 4 to 36 μmol/L, 10,11,15,16,24 respectively. Based on the available data, 34 of the 5227 LT recipients tested for HEV RNA had confirmed HEV infection at 5.5 to 96 months post‐LT 10,15,16,18,20,21 having mean/median AST, ALT and bilirubin levels from 29.5 to 250 IU/L, 15,16,18 22.8 to 250 IU/L 15,16,18,20,24 and 10.3 to 198 μmol/L, 15,16,18,20 respectively.…”

Section: Resultsmentioning

confidence: 99%

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Epidemiology and treatment of hepatitis E in the liver transplantation setting: A literature review

Markakis

Papatheodoridis

2022

Journal of Viral Hepatitis

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Hepatitis E virus (HEV) is a common cause of acute hepatitis in developing countries, but it can also take a chronic course especially in immunocompromised patients. Its epidemiology after liver transplantation (LT) is hard to assess and treatment options are still explored. Between 2009 and 2020, literature reporting HEV prevalence and treatment in LT recipients was searched and a synthesis was attempted. Sixteen studies reported HEV prevalence in consecutive LT patients: HEV RNA positivity ranged between 0%–1.4% and 0%–7.7% for Western and Eastern cohorts, respectively. In studies published between 2009–2014 and 2015–2020, HEV RNA positivity ranged between 0.35%–1.3% (all European) and 0%–7.7% (European: 0%–1.4%), respectively. Five studies evaluated HEV prevalence in LT recipients with abnormal liver enzymes: HEV RNA positivity was 2.9% in studies published between 2009 and 2014 and from 3.5% to 20% in studies published between 2015 and 2020. Twenty‐seven studies reported HEV treatment in LT recipients: sustained virologic response was achieved in 15% by immunosuppression reduction alone and in 83% of cases by ribavirin regiments. Chronic HEV infection is affecting LT recipients, mostly those with abnormal liver enzymes and in Eastern countries. HEV diagnoses should be based on PCR techniques. Successful treatment can be achieved with ribavirin in most cases.

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“…It is also more beneficial in immunosuppressed individuals, who don't mount or mount a very weak antibody response. (Majumdar et al, 2013) Antigen detection can be used as alternative to HEV RNA testing, especially in early phase of infection, immunocompromised patients and in settings where PCR facilities are not available (Majumdar et al, 2013;Soothill et al, 2018;Mishra et al, 2016). Singh et al, in an Indian study have shown that HEV antigen was a better marker than HEV RNA detection for the early diagnosis of illness (Majumdar et al, 2013).…”

Section: Cell Lines For Hevmentioning

confidence: 99%

Hepatitis E Virus and Zoonosis

Gupta¹,

Goyal²,

Singh³

2020

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Hepatitis E virus (HEV) is an important public health problem both in developing and developed nations. HEV is a single stranded RNA non-enveloped virus belonging to the family Hepeviridae. Globally, HEV is known to cause approximately 20 million infections per annum with a mortality of 44,000. The virus is endemic in developing nations and the outbreaks occur mainly in the post monsoon season when the drinking water gets contaminated with sewage. However, the mode of acquisition of infection is different in developed nations with good sanitary conditions where the infection is a zoonosis. Though the virus has only one serotype, 8 genotypes have been documented. Out of these, HEV 1 and 2 have been reported from developing countries and are transmitted mainly through faeco-oral route while HEV 3 and 4 are reported from developed countries and the infection is acquired by humans due to the eating of undercooked pigs, deer and wild boar meat. Recently HEV genotypes 5 and 6 have been reported in Japanese wild boars while HEV genotypes 7 and 8 have been reported in camels from Middle-East countries. Considering the increasing globalization of food markets, the possibility exists of widespread HEV infection in new areas of the world. In the present era, there is a need to study transmission dynamics of HEV in context to humans, animals and the environment so as to develop better prevention control measures through 'One Health' concept. The clinical manifestations of HEV can vary from self-limiting acute viral hepatitis which occurs in apparently healthy individuals to acute liver failure which leads to high mortality among pregnant women. Recently, chronic infections due HEV genotypes 3 and 4 have also been documented in immunosuppressed and transplant patients where prolonged virus shedding has been documented. The conventional diagnosis is established by detection of HEV antigen or anti-HEV IgM in acute sera. However, the detection of HEV RNA is important to establish the diagnosis in immunosuppressed patients. In transplant patients, decrease in immunosuppression is usually done, however ribavirin therapy has also shown a definitive role. There is upcoming literature on the role of sofosbuvir also in these groups of patients. Since the virus has only one serotype, univalent vaccine can provide protection against all HEV genotypes. Two vaccine candidates have been evaluated in clinical trials. Among these two vaccine candidates, one has been developed by Glaxosmithkline and another HEV 239 (Hecolin) has been developed by Innovax (China) and is in use in China since 2012. Considering the expanding clinical spectrum of HEV, it is an emerging zoonotic illness and prevention is the most effective approach against HEV.

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Diagnostic utility of hepatitis E virus antigen-specific ELISA versus PCR testing in a cohort of post liver transplant patients in a large university hospital

Cited by 7 publications

References 21 publications

Persistent Hepatitis E virus infection across England and Wales 2009‐2017: Demography, virology and outcomes

Persistent Hepatitis E virus infection across England and Wales 2009‐2017: Demography, virology and outcomes

Epidemiology and treatment of hepatitis E in the liver transplantation setting: A literature review

Hepatitis E Virus and Zoonosis

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