Evaluation of Urine as a Clinical Specimen for Diagnosis of Hepatitis A

Abstract

The present study pertains to the evaluation of urine as a specimen for detection of anti-hepatitis A virus (anti-HAV) antibodies. Immunoglobulin M (IgM), IgG, and IgA capture enzyme-linked immunosorbent assays for hepatitis A were performed on paired serum and urine specimens collected from hepatitis A patients (n ‫؍‬ 92), healthy individuals (n ‫؍‬ 100), non-A hepatitis patients (n ‫؍‬ 70), and patients with nonhepatic diseases (n ‫؍‬ 64, including 37 renal disease patients). Hepatitis A patients seropositive for anti-HAV IgM showed 95.65% uropositivity. No false-positive reactions were observed in control groups. The uropositivity of anti-HAV IgM persisted during the convalescent phase of the disease. Anti-HAV IgG uropositivity correlated well with corresponding seropositivity in all groups (P > 0.05 for each). No significant difference between the proportions of serum and urine positivity for anti-HAV IgA was noted (P > 0.05 for each). Using seroreactivity as a "gold standard," the sensitivity and specificity for anti-HAV IgM, anti-HAV IgG, and anti-HAV IgA tests with urine as a specimen were found to be 95.65 and 100%, 97.76 and 76.47%, and 92.23 and 88.18%, respectively. Urine appears to be comparable to serum for diagnosis of recent and past infection with hepatitis A.

Case report: Hepatitis A preceding Guillain–Barré Syndrome

“…The most striking feature in this patient was significantly high anti-HAV IgG titers as compared to that of the hepatitis A patients without the syndrome of present study and that reported previously [Joshi et al, 2002]. This may be indicative of clinical severity of HAV infection [Sata et al, 1996].…”

“…Anti-HAV IgG and IgA were detected in all serum samples by IgG and IgA capture ELISA [Joshi et al, 2002]. An IgM capture ELISA employed for the detection of recent infection with HAV validated at National Institute of Virology, Pune was found comparable to that of commercially available immunoassay from Abbott Laboratories (Chicago, IL) in its sensitivity and specificity [Chitambar et al, 1994].…”

Advantage of urine based molecular diagnosis of Zika virus

“…Diagnosis of other viral infections in urine and saliva samples has been reported for human immunodeficiency virus (HIV), Hepatitis A, B, and C, and rubella [14][15][16][17][18][19][20], and more recently in other flaviviruses, West-Nile virus (WNV) [21][22][23] and Dengue (DENV) serotypes -1, -2, -3, and -4 [24][25][26][27][28][29][30][31][32][33][34][35]. WNV can be detected longer in urine than serum [21] and can be isolated from urine [22,23].…”

Diagnosis of Hepatitis A Virus Infection: a Molecular Approach

“…IgG and IgA anti-HAV are detected in serum, saliva, urine, and feces (39,60,115,123,151,152,177,178,183,214). Saliva tests have been reported as an alternative to conventional serum testing for anti-HAV due to their simplicity of sample collection (115,177,178).…”