title: Discrepancy between anti-hepatitis E virus immunoglobulin G prevalence assessed by two assays in kidney and liver transplant recipients.
abstract: BACKGROUND
  Hepatitis E virus (HEV) is an emerging clinical threat in Europe among kidney and liver-transplant recipients. The incidence and prevalence of HEV infection in this special population are poorly known. False-negative results have been observed for anti-HEV IgG detection in severely immunocompromized persons. Moreover, large discrepancies have been reported between rates of anti-HEV IgG detection in blood donors and hepatitis E cases.
  
  
  OBJECTIVE
  To compare anti-HEV IgG and IgM prevalence using two different commercial microplate enzyme-immuno assays (MEIAs) (Adaltis and Wantai) in 64 kidney-/liver-transplant recipients.
  
  
  METHODS
  Serum samples tested in our routine clinical practice over the 12/2009-12/2011 period with Adaltis MEIAs were retrospectively tested using Wantai MEIAs. IgG-positive sera were further tested by an immunoblot while those found IgM-positive were further tested with an immunochromatography rapid test and for the presence of HEV RNA.
  
  
  RESULTS
  Positive results on anti-HEV IgG testing were obtained for seven (10.9%) compared to 20 (31.3%) serum samples with Adaltis and Wantai assays, respectively (p=0.005). Then, 6/7 (86%) of the serum samples positive with Adaltis and 16/20 (80%) of those positive with Wantai were positive with the immunoblot. One patient with chronic HEV infection was IgG-negative with both MEIAs. Regarding anti-HEV IgM, Adaltis and Wantai assays were concordant for 97% of the serum samples, prevalence being 8% with both MEIAs.
  
  
  CONCLUSIONS
  The accuracy of currently available commercial or in-house anti-HEV IgG MEIAs should be tested comparatively on a panel of serum samples collected from solid organ-transplant recipients, including some who experienced PCR-documented HEV infection.
authors.affiliation: Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, Centre Hospitalo-Universitaire Timone, Assistance Publique-Hôpitaux de Marseille, 264 rue Saint-Pierre 13385, Marseille CEDEX 05, France.
authors.forename: Morgane
authors.initials: M
authors.lastname: Rossi-Tamisier
authors.forename: Valérie
authors.initials: V
authors.lastname: Moal
authors.forename: René
authors.initials: R
authors.lastname: Gerolami
authors.forename: Philippe
authors.initials: P
authors.lastname: Colson
mesh_terms: D000914:Antibodies, Viral / Q000097:blood*; D002846:Chromatography, Affinity / Q000379:methods; D005060:Europe; D016751:Hepatitis E / Q000175:diagnosis* / Q000453:epidemiology; D016752:Hepatitis E virus / Q000276:immunology*; D006801:Humans; D015151:Immunoblotting / Q000379:methods; D016867:Immunocompromised Host; D007124:Immunoenzyme Techniques / Q000379:methods*; D007074:Immunoglobulin G / Q000097:blood*; D007075:Immunoglobulin M / Q000097:blood; D016030:Kidney Transplantation / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects; D012367:RNA, Viral / Q000097:blood; D016036:Seroepidemiologic Studies; D014180:Transplantation
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D012367:RNA, Viral