Seroreactivity to hepatitis E virus in areas where the disease is not endemic

Thomas, David L.; Yarbough, Patrice O.; Vlahov, David; Tsarev, Sergei A.; Nelson, Kenrad E.; Saah, Alfred J.; Purcell, Robert H.

doi:10.1128/jcm.35.5.1244-1247.1997

Cited by 209 publications

(98 citation statements)

References 14 publications

(22 reference statements)

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“…In the developed countries, it is generally believed that only those who travel to endemic areas face the risk of HEV infection [Bader et al, 1991;Skidmore et al, 1991;Dawson et al, 1992b;Lau et al, 1995]. Nevertheless, anti-HEV was found in a significant proportion, up to 28% in some areas, of healthy individuals in developed countries [Dawson 1992;Thomas et al 1997]. Whether this was due to subclinical HEV infection or to a nonspecific reaction remains to be clarified.…”

Section: Discussionmentioning

confidence: 99%

Identification of a novel strain of hepatitis E virus responsible for sporadic acute hepatitis in Taiwan

Hsieh

Yang

et al. 1998

J. Med. Virol.

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Hepatitis caused by the hepatitis E virus (HEV) is a self-limited disease and occurs most frequently as epidemic or sporadic hepatitis in developing countries. The role of HEV in sporadic acute hepatitis in areas without a history of hepatitis E epidemics is obscure. Recently, it was found that more than 10% of the patients with acute non-A, non-B, non-C hepatitis in Taiwan were associated with an acute HEV infection. Nucleotide sequences of the regions within the first open reading frame of HEV were determined in four cases and were 96.7-100% identical to each other. As compared to the isolates from China, Pakistan, Burma, India, Africa, and Mexico, the similarities were, however, only 71.7-79.3%. Phylogenetic analysis revealed that the four Taiwan isolates were categorized as a novel HEV group (the Taiwan strain), which was distinct from all of the strains isolated from other parts of the world. In addition, the isolates from China, Burma, India, and Pakistan were catalogued as the second genotype of HEV (the Asian strain), and the Mexican isolate as the third (the Mexican strain). The African isolate was more related to the Asian type and might be a subtype of the Asian strain. A simple genotyping method by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) is described. The findings also support the hypothesis that HEV may be responsible for some sporadic acute non-A, non-B, non-C hepatitis in other developed countries.

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Section: Discussionmentioning

confidence: 99%

Identification of a novel strain of hepatitis E virus responsible for sporadic acute hepatitis in Taiwan

Hsieh

Yang

et al. 1998

J. Med. Virol.

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“…10 Anti-HEV seroprevalence rates ranging from 15.9% to 23% have been reported from various selected populations in the United States. 11 An assessment of hepatitis E seroprevalence in the United…”

Section: Introductionmentioning

confidence: 99%

Variability in the performance characteristics of IgG anti‐HEV assays and its impact on reliability of seroprevalence rates of hepatitis E

Kodani

Kamili

Tejada‐Strop

et al. 2016

Journal of Medical Virology

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Hepatitis E is a major public health problem in developing countries and is increasingly being recognized as a cause of substantial sporadic viral hepatitis infections in industrialized countries. Variable rates of hepatitis E seroprevalence have been reported from the same geographic regions depending on the assay used. In this study, we evaluated the performance characteristics of four assays which included two commercial assays, Wantai HEV-IgG ELISA kit (Wantai, China), and DS-EIA-ANTI-HEV-G kit (DSI, Italy), one NIH-developed immunoassay (NIH-55 K, Kuniholm et al. [2009] Journal of Infectious Diseases 200:48-56), previously used in several major seroprevalence studies and one in-house Western blot assay (CDC-WB). The limit of detection of IgG anti-HEV is 100 mIU/mL for Wantai assay, 200 mIU/mL for CDC-WB assay, 1000 mIU/mL for DSI assay, and 40 mIU/mL for NIH-55 K assay. Pairwise concordance between the four assays ranged from 56% to 87%. The concordance among all four assays was observed in 52% of the samples, while the concordance among three assays was observed in 37% of the samples. These data show a wide discordance between various IgG anti-HEV assays and warrant a comprehensive evaluation of all the assays using well characterized global serum reference panels.

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“…(1) Lifetime exposure to HEV-as indicated by the presence of HEV immunoglobulin (Ig) G in serum or plasma-is common in the United States and many European countries, although estimates of HEV IgG seroprevalence vary widely (e.g., 6%-53%) and depend on the choice of HEV serologic assay, the age of the study population, and the geographical region. (10)(11)(12)(13)(14) It is believed that most HEV genotype 3 and 4 infections in humans are asymptomatic, with only a small fraction of infections manifesting as acute hepatitis. (15) Abbreviations: ALT, alanine aminotransferase; APRI, aspartate-to-platelet ratio; AST However, in some European countries, hundreds of HEV genotype 3-associated acute hepatitis cases are identified annually.…”

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confidence: 99%

Acute and Chronic Hepatitis E Virus Infection in Human Immunodeficiency Virus‐Infected U.S. Women

et al. 2016

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Exposure to hepatitis E virus (HEV) is common in the United States (US) but there are few data on prevalence of HEV/HIV co-infection in US populations. We tested 2,919 plasma samples collected from HIV-infected (HIV+) women and men enrolled in US cohort studies for HEV viremia using a high-throughput nucleic acid testing (NAT) platform. NAT+ samples were confirmed by real-time polymerase chain reaction (PCR). Samples were selected for testing primarily on the basis of biomarkers of liver disease and immune suppression. Prevalence of HEV viremia was 3/2,606 and 0/313 in tested plasma samples collected from HIV+ women and men, respectively. All HEV isolates were genotype 3a. Based on follow-up testing of stored samples, one woman had chronic HEV infection for >4 years while 2 women had acute HEV detectable at only a single study visit. Conclusion To our knowledge this is the first reported case of chronic HEV infection in an HIV+ US individual. We also confirm that chronic HEV infection can persist despite a CD4+ count >200 cells/mm3. These data suggest that HEV infection is rare in the HIV+ US population.

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Seroreactivity to hepatitis E virus in areas where the disease is not endemic

Cited by 209 publications

References 14 publications

Identification of a novel strain of hepatitis E virus responsible for sporadic acute hepatitis in Taiwan

Identification of a novel strain of hepatitis E virus responsible for sporadic acute hepatitis in Taiwan

Variability in the performance characteristics of IgG anti‐HEV assays and its impact on reliability of seroprevalence rates of hepatitis E

Acute and Chronic Hepatitis E Virus Infection in Human Immunodeficiency Virus‐Infected U.S. Women

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