Relationships among viral diagnostic markers and markers of liver function in acute hepatitis E.
BACKGROUND
Diagnosis of acute hepatitis E has been based in many clinics predominantly on detection of anti-HEV (hepatitis E virus) antibody. Now, new assays have been developed to detect other HEV markers. Our aim was to investigate the relationships among HEV diagnostic markers and liver function markers in acute hepatitis E.


METHODS
Seventy serum samples were collected from non-A, non-B, non-C acute hepatitis patients and tested for HEV markers (HEV antigen and RNA and anti-HEV IgM) and markers of liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total iron binding capacity (TBA), gamma-glutamyl transferase (GGT), total bilirubin (TBIL), and direct bilirubin (DBIL)]. Partial open reading frame (ORF) 2 sequences from HEV RNA-positive samples were cloned and analyzed.


RESULTS
The concordances between HEV antigen and HEV RNA and between HEV antigen and anti-HEV IgM were 77.1% and 72.9%, respectively, with significant correlations, while that between HEV RNA and anti-HEV IgM was 61.4% with no significant correlation. Eleven of 25 samples negative for anti-HEV IgM were positive for HEV antigen. The ALT, AST, ALP, TBA, GGT, TBIL, and DBIL levels did not differ significantly between the anti-HEV IgM-positive and -negative groups. However, the ALT, AST, ALP, TBA, and GGT levels were significantly higher in the HEV antigen-positive group than in the HEV antigennegative group. All of the HEV isolates cloned belonged to genotype 4.


CONCLUSIONS
HEV antigen was highly correlated with HEV RNA and elevated ALT, AST, ALP, TBA, and GGT levels. Testing for HEV antigen in combination with anti-HEV IgM is useful for the diagnosis of HEV infection.
Zhao
Chenyan
C
Department of Cell Biology, National Institute for the Control of Pharmaceutical and Biological Products, No. 2 Tiantanxili, Beijing 100050, China.
Li
Luping
L
Harrison
Tim J
TJ
Wang
Qin
Q
Song
Aijing
A
Fan
Jinping
J
Ma
Hongxa
H
Zhang
Chuntao
C
Wang
Youchun
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000378:metabolism; D005260:Female; D006508:Hepatitis Antibodies / Q000097:blood; D018963:Hepatitis Antigens / Q000097:blood; D016751:Hepatitis E / Q000175:diagnosis* / Q000378:metabolism*; D016752:Hepatitis E virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012367:RNA, Viral / Q000097:blood; D000637:Transaminases / Q000097:blood; D055815:Young Adult; D005723:gamma-Glutamyltransferase / Q000097:blood
D015415:Biomarkers; D006508:Hepatitis Antibodies; D018963:Hepatitis Antigens; D012367:RNA, Viral; D005723:gamma-Glutamyltransferase; D000637:Transaminases; D001663:Bilirubin