Hepatitis E ; diagnosis ; Humans

BACKGROUND: After an infection with HBV, HBsAg is the first virologic marker detectable in the serum. If anti-HBs against 'a'determinant of HBsAg appears, HBsAg will disappear and the patients will recover from the HBV infection in most cases. However, we encounter not infrequently concomitant cases of HBsAg and anti-HBs. In this study we evaluated HBV DNA levels in concomitant cases to aid in the interpretation of these serologic results. METHODS: This study included 36 cases with positivity for both HBsAg and anti-HBs in an electrochemiluminescent immunoassay as well as a radioimmunoassay. They were tested for HBeAg, anti-HBe, and HBV DNA levels. RESULTS: Chronic viral hepatitis was the most frequent diagnosis (15/36 : 41.7%) and AST and ALT levels were normal in 17 (47.2%) and 20 (55.6%) cases, respectively, among total 36 concomitant cases. HBeAg was positive in 24 and anti-HBe in 17 cases. HBV DNA was positive in 33 cases (91.7%). including all 24 HBeAg positive cases and 9 (75%) of 12 HBeAg negative cases; 6 (50%) of 12 HBeAg negative cases had HBV DNA levels higher than 105 copy/mL. CONCLUSIONS: This study showed that viral replication still exists in most cases of concomitant HBsAg and anti-HBs, and even in some HBeAg negative cases. So in the concomitant cases, HBV DNA quantitation may aid in the interpretation of clinical significance of these cases.
Diagnosis ; DNA ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens* ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Immunoassay ; Radioimmunoassay

OBJECTIVETo evaluate the serological markers and biological marker in the diagnosis of hepatitis E infection in a rhesus monkey model.

METHODS86 rhesus monkeys had been infected with different doses of HEV. Hence, they were taken sequential blood samples at intervals up to 86 weeks for 4 hepatitis E virus (HEV) specific antibody assays (E2-IgM, E2-IgG, GL-IgG, and YES-IgG), and nucleic acid assay.

RESULTSAll the animals produced E2-IgG and all but one also produced E2-IgM and excreted the virus in stool, whereas positive rate of GL-IgG and YES IgG were low and correlated with virus level. Hepatitis occurred over a period of 4 weeks (between 3 an 7 weeks) after infection. Virological marker occurred mainly during incubation period and declined rapidly after onset of hepatitis. Seroconversion of E2-IgM occurred before onset of hepatitis in 70% monkeys and declined rapidly up to 50% of peak value after 4 weeks. E2-IgM seroconversion was closely paralleled by E2-IgG; however, E2-IgG persisted in all animals for the entire duration of experiment of up to 86 weeks. Production of GL-IgG and YES-IgG was delayed by one week after the E2 antibodies, these antibodies showed a transient occurrence and seroprevalence declined to 50% of the peak value over a period of 12 weeks.

CONCLUSIONE2-IgM might be used as a suitable acute hepatitis E marker, and E2-IgG as a suitable epidemiological marker. The seroconversion or titer elevation of GL-IgG and YES-IgG antibodies probably used to confirm the infection. The viral markers are optional for early diagnosis.

Alanine Transaminase ; blood ; Animals ; Biomarkers ; Genotype ; Hepatitis Antibodies ; blood ; Hepatitis E ; diagnosis ; Hepatitis E virus ; classification ; genetics ; immunology ; Immunoglobulin E ; blood ; Immunoglobulin M ; blood ; Macaca mulatta

The HEV is a known cause of water-borne outbreaks of acute non-A non-B hepatitis in developing countries, which affects young people and may result in high mortality in pregnant women. In recent decades, however, HEV genotypes 3 and 4 have been known as a cause of sporadic zoonotic infections in older males from swine HEV worldwide. Most acute HEV infections are self-limited. On the other hand, in immunosuppressed patients, including solid organ transplant recipients, chronic HEV infections may exist and progress to liver cirrhosis or decompensation. Therefore, physicians need to recognize HEV as a major pathogen for acute and chronic hepatitis of unknown causes and investigate this disease.
Developing Countries ; Diagnosis ; Disease Outbreaks ; Female ; Genotype ; Hand ; Hepatitis E virus ; Hepatitis E ; Hepatitis ; Hepatitis, Chronic ; Humans ; Liver Cirrhosis ; Male ; Mortality ; Pregnant Women ; Swine ; Transplants ; Waterborne Diseases ; Zoonoses

The HEV is a known cause of water-borne outbreaks of acute non-A non-B hepatitis in developing countries, which affects young people and may result in high mortality in pregnant women. In recent decades, however, HEV genotypes 3 and 4 have been known as a cause of sporadic zoonotic infections in older males from swine HEV worldwide. Most acute HEV infections are self-limited. On the other hand, in immunosuppressed patients, including solid organ transplant recipients, chronic HEV infections may exist and progress to liver cirrhosis or decompensation. Therefore, physicians need to recognize HEV as a major pathogen for acute and chronic hepatitis of unknown causes and investigate this disease.
Developing Countries ; Diagnosis ; Disease Outbreaks ; Female ; Genotype ; Hand ; Hepatitis E virus ; Hepatitis E ; Hepatitis ; Hepatitis, Chronic ; Humans ; Liver Cirrhosis ; Male ; Mortality ; Pregnant Women ; Swine ; Transplants ; Waterborne Diseases ; Zoonoses

Acute Disease ; Anemia, Hemolytic ; diagnosis ; etiology ; Coombs Test ; Hepatitis E ; complications ; diagnosis ; Humans ; Male ; Middle Aged

OBJECTIVETo evaluate two commercial anti-hepatitis E virus (HEV) IgM kits used for differential diagnosis of acute enteric viral hepatitis.

METHODSThe kit for IgM capture assay, was produced with a recombinant HEV structural protein protecting primates against experimental infection by different HEV genotypes, while the other kit for indirect ELISA was produced with recombinant structural proteins from different HEV genotypes. The serum specimens were taken from 241 cases with a confirmed or presumptive diagnosis of hepatitis A and 74 cases with a confirmed or presumptive diagnosis of hepatitis E.

RESULTSThe sensitivity and specificity of the IgM capture assay kit were 97% and 100%, respectively, and the corresponding values for the other kit were 70% and 78%, respectively.

CONCLUSIONThe IgM capture assay kit has higher sensitivity and specificity in diagnosing acute enteric viral hepatitis E.

Diagnosis, Differential ; Hepatitis E ; diagnosis ; immunology ; Humans ; Immunoglobulin M ; blood ; immunology ; Reagent Kits, Diagnostic ; Sensitivity and Specificity

OBJECTIVETo evaluate the reliability of different hepatitis E diagnosis reagent tests on the acute hepatitis E.

METHODSThree acute hepatitis E diagnosis tests, E2-IgM (Wantai, China), GL-IgM and GL-IgG (Genelabs, Singapore) were compared for their reliability in a sera panel composed by 273 healthy individuals and 525 hepatitis.

RESULTSThe specificity of E2-IgM on the diagnosis of acute hepatitis E was 100.0%, it was significantly higher than GL-IgM (96.7%) and GL-IgG (85.4%). The sensitivity of E2-IgM and GL-IgG were 97.9% and 93.8% respectively, both significantly higher than GL-IgM (72.9%). Among 65 acute hepatitis cases being positive on GL-IgM test but negative on E2-IgM, 58 (89.2%) cases were found to be positive with anti-hepatitis A virus IgM, it indicated that the GL-IgM test might be interfered by other IgM antibodies on serum.

CONCLUSIONE2-IgM is a good test for the diagnosis of acute hepatitis E.

Acute Disease ; Hepatitis Antibodies ; blood ; Hepatitis E ; diagnosis ; Humans ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood ; Reagent Kits, Diagnostic ; Sensitivity and Specificity

Adult ; Female ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; blood ; diagnosis ; Humans ; Male ; Middle Aged ; Prognosis

Acute hepatitis E is an endemic disease, commonly reported in Indian subcontinent, China, Africa, Central America, and so forth. It is a self-limiting disease like other acute hepatitis except in pregnant patient. Although sporadic hepatitis E is noted all over the world, most of them are associated with travel history to HEV-endemic area. In Korea, Hepatitis E is rarely reported. Moreover, sporadic acute hepatitis E without travel history to HEV-endemic area is very rare. We experienced three sporadic cases of acute hepatitis E, without travel history. All of them presented acute hepatitis symptoms, elevated aminotransferase, and positive IgM HEV Ab. Symptoms and aminotransferase levels were normalized during hospitalization and IgM HEV Ab converted negative after 4-8 months. We report three sporadic cases of onset-acute hepatitis E without travel history to HEV-endemic area.
Acute Disease ; Adult ; Alanine Transaminase/analysis ; Aspartate Aminotransferases/analysis ; Female ; Hepatitis E/*diagnosis ; Humans ; Male