title: Variability of hepatitis E serologic assays in a pediatric liver transplant recipient: challenges to diagnosing hepatitis E virus infection in the United States.
abstract: Hepatitis E virus (HEV) is an emerging cause of viral hepatitis among immunocompromised individuals in developed countries. Yet the diagnosis of HEV infection in the United States remains challenging, because of the variable sensitivity and specificity of currently available tests, and the lack of a US Food and Drug Administration-approved test. We report a case of multiple discordant HEV serology results in a pediatric liver transplant recipient with idiopathic hepatitis, and review the challenges to diagnosis of HEV infection in the United States.
authors: Division of Pediatric Infectious Disease, Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors: P K
authors: PK
authors: Sue
authors: N
authors: N
authors: Pisanic
authors: C D
authors: CD
authors: Heaney
authors: T
authors: T
authors: Mixson-Hayden
authors: S
authors: S
authors: Kamili
authors: K
authors: K
authors: Nelson
authors: K B
authors: KB
authors: Schwarz
authors: M
authors: M
authors: Forman
authors: A
authors: A
authors: Valsamakis
authors: J
authors: J
authors: Ticehurst
authors: W
authors: W
authors: Karnsakul
mesh_terms: D001656:Biliary Atresia / Q000601:surgery*; D002487:Centers for Disease Control and Prevention, U.S.; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006508:Hepatitis Antibodies / Q000276:immunology*; D016751:Hepatitis E / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D016752:Hepatitis E virus / Q000276:immunology*; D006801:Humans; D016867:Immunocompromised Host; D007074:Immunoglobulin G / Q000276:immunology; D007075:Immunoglobulin M / Q000276:immunology; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016031:Liver Transplantation; D012367:RNA, Viral / Q000097:blood*; D012698:Serologic Tests / Q000592:standards*; D014481:United States
chemical_list: D006508:Hepatitis Antibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D007166:Immunosuppressive Agents; D012367:RNA, Viral
keywords: hepatitis E virus; liver transplantation; viral diagnostics
references: Transpl Infect Dis. 2013 Aug;15(4):E166-8
references: 23701647
references: Gastroenterology. 2011 May;140(5):1481-9
references: 21354150
references: J Clin Virol. 2013 Dec;58(4):629-34
references: 24210958
references: N Engl J Med. 2014 Mar 20;370(12):1111-20
references: 24645943
references: J Infect Dis. 2015 Feb 1;211(3):366-73
references: 25147277
references: Virus Res. 2011 Oct;161(1):84-92
references: 21704091
references: J Infect Dis. 2009 Jul 1;200(1):48-56
references: 19473098
references: N Engl J Med. 2008 Feb 21;358(8):811-7
references: 18287603
references: Lancet Infect Dis. 2008 Nov;8(11):698-709
references: 18992406
references: Transplant Proc. 2013 Mar;45(2):810-3
references: 23498824
references: Clin Infect Dis. 2010 Aug 1;51(3):e24-7
references: 20578874
references: J Clin Virol. 2013 Sep;58(1):36-40
references: 23886501
references: Emerg Infect Dis. 2013 Feb;19(2):218-22; quiz 353
references: 23347695
references: J Infect Dis. 2010 Sep 15;202(6):835-44
references: 20695798
references: Expert Rev Anti Infect Ther. 2011 Dec;9(12):1133-48
references: 22114964
references: Lancet. 2012 Jun 30;379(9835):2477-2488
references: 22549046
references: J Virol Methods. 2006 Jan;131(1):65-71
references: 16125257
references: Biomed Environ Sci. 2007 Dec;20(6):512-5
references: 18348412
references: J Med Virol. 2010 May;82(5):799-805
references: 20336757