Profile of acute infectious markers in sporadic hepatitis E.
Laboratory diagnosis of acute infection of hepatitis E virus (HEV) is commonly based on the detection of HEV RNA, IgM and/or rising IgG levels. However, the profile of these markers when the patients present have not been well determined. To clarify the extent of misdiagnosed sporadic hepatitis E in the initial laboratory detection, serial sera of 271 sporadic acute hepatitis cases were collected, detected and the dynamics of each acute marker during the illness course were analyzed. 91 confirmed cases of hepatitis E were identified based on the presentation of HEV RNA, IgM or at least 4 fold rising of IgG levels. 21 (23.1%) hepatitis E cases were false negative for the viral RNA and 40 (44.0%) for rising IgG, because occurrence of these markers were confined to acute phase of infection and viremia had already subsided and antibody level peaked when these patients presented. IgM was detected in 82 (90.1%) cases. It is the most prevalent of the three markers, because the antibody persisted until early convalescence. Nine cases negative for IgM were positive for rising IgG and one was also positive for the viral RNA; all of these nine cases showed high avid IgG in their acute phase sera, which indicated re-infection. In summary, it is not practicable to determine the true occurrence of sporadic hepatitis E. Nevertheless, it could be closely approximated by approach using a combination of all three acute markers.
National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Xiamen University, Xiamen, China.
Shoujie
S
Huang
Xuefeng
X
Zhang
Hanmin
H
Jiang
Qiang
Q
Yan
Xing
X
Ai
Yijun
Y
Wang
Jiaping
J
Cai
Lang
L
Jiang
Ting
T
Wu
Zhongze
Z
Wang
Li
L
Guan
J Wai Kuo
JW
Shih
Mun-Hon
MH
Ng
Fengcai
F
Zhu
Jun
J
Zhang
Ningshao
N
Xia
D000208:Acute Disease; D001483:Base Sequence; D015415:Biomarkers / Q000097:blood*; D017931:DNA Primers; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D016751:Hepatitis E / Q000097:blood*; D016752:Hepatitis E virus / Q000235:genetics; D006801:Humans; D012367:RNA, Viral / Q000097:blood
D015415:Biomarkers; D017931:DNA Primers; D012367:RNA, Viral