Hepatitis E virus antigen detection as an early diagnostic marker: Report from India
Hepatitis E virus (HEV) is implicated in many outbreaks of viral hepatitis in the Indian subcontinent. The conventional diagnosis of such outbreaks rests on the detection of anti‐HEV IgM antibodies. However, IgM antibodies develop after 4–5 days of infection. An early‐diagnostic marker is imperative...
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| Veröffentlicht in: | Journal of medical virology 2013-05, Vol.85 (5), p.823-827 |
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| container_title | Journal of medical virology |
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| creator | Majumdar, Manasi Singh, Mini P. Pujhari, Sujit Kumar Bhatia, Deepak Chawla, Y. Ratho, R.K. |
| description | Hepatitis E virus (HEV) is implicated in many outbreaks of viral hepatitis in the Indian subcontinent. The conventional diagnosis of such outbreaks rests on the detection of anti‐HEV IgM antibodies. However, IgM antibodies develop after 4–5 days of infection. An early‐diagnostic marker is imperative for timely diagnosis of the outbreak and also initiation of control measures. This study aimed to determine the use of hepatitis E virus antigen detection as an early diagnostic marker in an outbreak in comparison to anti‐HEV IgM and RT‐PCR analyses. Forty samples were collected during a suspected outbreak of viral hepatitis due to HEV. A total of 36 samples were positive for one or more HEV markers. The positivity for anti‐HEV IgM, HEV antigen, and RT‐PCR was 91.6%, 69.4%, and 47.2% respectively. RT‐PCR and HEV antigen detection gave the highest positive results (100%) in the first 3 days of illness. Positive HEV PCR declined to 54% by Days 4–7, whereas HEV antigen and IgM detection were 88% and 100%, respectively. Sequencing of representative HEV samples indicated that the strains responsible for this outbreak belonged to genotype I, subtype 1a. HEV antigen was found to be an early diagnostic marker of acute infection. HEV antigen was detected in three additional cases in the early phase (1–3 days), and they had no detectable anti‐HEV IgM antibodies. These three samples were also positive for HEV RNA. After Day 7, anti‐HEV IgM was the main diagnostic indicator of infection. J. Med. Virol. 85:823–827, 2013. © 2013 Wiley Periodicals, Inc. |
| doi_str_mv | 10.1002/jmv.23529 |
| format | Article |
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The conventional diagnosis of such outbreaks rests on the detection of anti‐HEV IgM antibodies. However, IgM antibodies develop after 4–5 days of infection. An early‐diagnostic marker is imperative for timely diagnosis of the outbreak and also initiation of control measures. This study aimed to determine the use of hepatitis E virus antigen detection as an early diagnostic marker in an outbreak in comparison to anti‐HEV IgM and RT‐PCR analyses. Forty samples were collected during a suspected outbreak of viral hepatitis due to HEV. A total of 36 samples were positive for one or more HEV markers. The positivity for anti‐HEV IgM, HEV antigen, and RT‐PCR was 91.6%, 69.4%, and 47.2% respectively. RT‐PCR and HEV antigen detection gave the highest positive results (100%) in the first 3 days of illness. Positive HEV PCR declined to 54% by Days 4–7, whereas HEV antigen and IgM detection were 88% and 100%, respectively. Sequencing of representative HEV samples indicated that the strains responsible for this outbreak belonged to genotype I, subtype 1a. HEV antigen was found to be an early diagnostic marker of acute infection. HEV antigen was detected in three additional cases in the early phase (1–3 days), and they had no detectable anti‐HEV IgM antibodies. These three samples were also positive for HEV RNA. After Day 7, anti‐HEV IgM was the main diagnostic indicator of infection. J. Med. Virol. 85:823–827, 2013. © 2013 Wiley Periodicals, Inc.</description><identifier>ISSN: 0146-6615</identifier><identifier>EISSN: 1096-9071</identifier><identifier>DOI: 10.1002/jmv.23529</identifier><identifier>PMID: 23408566</identifier><identifier>CODEN: JMVIDB</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Adult ; Antigens ; Antigens, Viral - blood ; Biological and medical sciences ; Biomarkers ; Biomarkers - blood ; Disease Outbreaks ; ELISA ; Female ; Fundamental and applied biological sciences. Psychology ; Genotypes ; Hepatitis ; Hepatitis Antibodies - blood ; Hepatitis E - diagnosis ; Hepatitis E - epidemiology ; Hepatitis E virus ; Hepatitis E virus - isolation & purification ; HEV antigen ; Human viral diseases ; Humans ; Immunoglobulin M - blood ; India - epidemiology ; Infectious diseases ; Male ; Medical sciences ; Microbiology ; Middle Aged ; Miscellaneous ; Molecular Sequence Data ; outbreak ; outbreak, ELISA ; Reverse Transcriptase Polymerase Chain Reaction ; RNA, Viral - blood ; RNA, Viral - genetics ; Sensitivity and Specificity ; Sequence Analysis, DNA ; sequencing ; Time Factors ; Viral diseases ; Virology ; Young Adult</subject><ispartof>Journal of medical virology, 2013-05, Vol.85 (5), p.823-827</ispartof><rights>Copyright © 2013 Wiley Periodicals, Inc.</rights><rights>2014 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4549-43f86fa552b44d326496b1877d6c5aabc431b5297b2debe0fd432cdb89b42973</citedby><cites>FETCH-LOGICAL-c4549-43f86fa552b44d326496b1877d6c5aabc431b5297b2debe0fd432cdb89b42973</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjmv.23529$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjmv.23529$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27179479$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23408566$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Majumdar, Manasi</creatorcontrib><creatorcontrib>Singh, Mini P.</creatorcontrib><creatorcontrib>Pujhari, Sujit Kumar</creatorcontrib><creatorcontrib>Bhatia, Deepak</creatorcontrib><creatorcontrib>Chawla, Y.</creatorcontrib><creatorcontrib>Ratho, R.K.</creatorcontrib><title>Hepatitis E virus antigen detection as an early diagnostic marker: Report from India</title><title>Journal of medical virology</title><addtitle>J. Med. Virol</addtitle><description>Hepatitis E virus (HEV) is implicated in many outbreaks of viral hepatitis in the Indian subcontinent. The conventional diagnosis of such outbreaks rests on the detection of anti‐HEV IgM antibodies. However, IgM antibodies develop after 4–5 days of infection. An early‐diagnostic marker is imperative for timely diagnosis of the outbreak and also initiation of control measures. This study aimed to determine the use of hepatitis E virus antigen detection as an early diagnostic marker in an outbreak in comparison to anti‐HEV IgM and RT‐PCR analyses. Forty samples were collected during a suspected outbreak of viral hepatitis due to HEV. A total of 36 samples were positive for one or more HEV markers. The positivity for anti‐HEV IgM, HEV antigen, and RT‐PCR was 91.6%, 69.4%, and 47.2% respectively. RT‐PCR and HEV antigen detection gave the highest positive results (100%) in the first 3 days of illness. Positive HEV PCR declined to 54% by Days 4–7, whereas HEV antigen and IgM detection were 88% and 100%, respectively. Sequencing of representative HEV samples indicated that the strains responsible for this outbreak belonged to genotype I, subtype 1a. HEV antigen was found to be an early diagnostic marker of acute infection. HEV antigen was detected in three additional cases in the early phase (1–3 days), and they had no detectable anti‐HEV IgM antibodies. These three samples were also positive for HEV RNA. After Day 7, anti‐HEV IgM was the main diagnostic indicator of infection. J. Med. Virol. 85:823–827, 2013. © 2013 Wiley Periodicals, Inc.</description><subject>Adult</subject><subject>Antigens</subject><subject>Antigens, Viral - blood</subject><subject>Biological and medical sciences</subject><subject>Biomarkers</subject><subject>Biomarkers - blood</subject><subject>Disease Outbreaks</subject><subject>ELISA</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Genotypes</subject><subject>Hepatitis</subject><subject>Hepatitis Antibodies - blood</subject><subject>Hepatitis E - diagnosis</subject><subject>Hepatitis E - epidemiology</subject><subject>Hepatitis E virus</subject><subject>Hepatitis E virus - isolation & purification</subject><subject>HEV antigen</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immunoglobulin M - blood</subject><subject>India - epidemiology</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Microbiology</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Molecular Sequence Data</subject><subject>outbreak</subject><subject>outbreak, ELISA</subject><subject>Reverse Transcriptase Polymerase Chain Reaction</subject><subject>RNA, Viral - blood</subject><subject>RNA, Viral - genetics</subject><subject>Sensitivity and Specificity</subject><subject>Sequence Analysis, DNA</subject><subject>sequencing</subject><subject>Time Factors</subject><subject>Viral diseases</subject><subject>Virology</subject><subject>Young Adult</subject><issn>0146-6615</issn><issn>1096-9071</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0V1rFDEUBuAgil2rF_4BCYigF9PmO5PeyVLbSl1Flu1lSDKZknU-1iRT3X9v1t1WEMSrwOE553DyAvASoxOMEDld93cnhHKiHoEZRkpUCkn8GMwQZqISAvMj8CylNUKoVoQ8BUeEMlRzIWZgeek3JoccEjyHdyFOCZohh1s_wMZn73IYB2h2RehN7LawCeZ2GFMODvYmfvPxDH71mzFm2Maxh1dDAc_Bk9Z0yb84vMdg-eF8Ob-srj9fXM3fX1eOcaYqRttatIZzYhlrKBFMCYtrKRvhuDHWMYptuUpa0njrUdswSlxja2VZqdJj8HY_dhPH75NPWfchOd91ZvDjlDRmjFJJEBX_pxTXSHEleaGv_6LrcYpDuaMMpDWWgjFS1Lu9cnFMKfpWb2IoH7LVGOldKLqEon-HUuyrw8TJ9r55kPcpFPDmAExypmujGVxIf5zEUjG5G3S6dz9C57f_3qg_flrdr672HSFl__OhowSnhaSS65vFhV7c4JX6spjrFf0FZ0-waw</recordid><startdate>201305</startdate><enddate>201305</enddate><creator>Majumdar, Manasi</creator><creator>Singh, Mini P.</creator><creator>Pujhari, Sujit Kumar</creator><creator>Bhatia, Deepak</creator><creator>Chawla, Y.</creator><creator>Ratho, R.K.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7TK</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>201305</creationdate><title>Hepatitis E virus antigen detection as an early diagnostic marker: Report from India</title><author>Majumdar, Manasi ; Singh, Mini P. ; Pujhari, Sujit Kumar ; Bhatia, Deepak ; Chawla, Y. ; Ratho, R.K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4549-43f86fa552b44d326496b1877d6c5aabc431b5297b2debe0fd432cdb89b42973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Antigens</topic><topic>Antigens, Viral - blood</topic><topic>Biological and medical sciences</topic><topic>Biomarkers</topic><topic>Biomarkers - blood</topic><topic>Disease Outbreaks</topic><topic>ELISA</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Genotypes</topic><topic>Hepatitis</topic><topic>Hepatitis Antibodies - blood</topic><topic>Hepatitis E - diagnosis</topic><topic>Hepatitis E - epidemiology</topic><topic>Hepatitis E virus</topic><topic>Hepatitis E virus - isolation & purification</topic><topic>HEV antigen</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Immunoglobulin M - blood</topic><topic>India - epidemiology</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Microbiology</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Molecular Sequence Data</topic><topic>outbreak</topic><topic>outbreak, ELISA</topic><topic>Reverse Transcriptase Polymerase Chain Reaction</topic><topic>RNA, Viral - blood</topic><topic>RNA, Viral - genetics</topic><topic>Sensitivity and Specificity</topic><topic>Sequence Analysis, DNA</topic><topic>sequencing</topic><topic>Time Factors</topic><topic>Viral diseases</topic><topic>Virology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Majumdar, Manasi</creatorcontrib><creatorcontrib>Singh, Mini P.</creatorcontrib><creatorcontrib>Pujhari, Sujit Kumar</creatorcontrib><creatorcontrib>Bhatia, Deepak</creatorcontrib><creatorcontrib>Chawla, Y.</creatorcontrib><creatorcontrib>Ratho, R.K.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of medical virology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Majumdar, Manasi</au><au>Singh, Mini P.</au><au>Pujhari, Sujit Kumar</au><au>Bhatia, Deepak</au><au>Chawla, Y.</au><au>Ratho, R.K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hepatitis E virus antigen detection as an early diagnostic marker: Report from India</atitle><jtitle>Journal of medical virology</jtitle><addtitle>J. Med. Virol</addtitle><date>2013-05</date><risdate>2013</risdate><volume>85</volume><issue>5</issue><spage>823</spage><epage>827</epage><pages>823-827</pages><issn>0146-6615</issn><eissn>1096-9071</eissn><coden>JMVIDB</coden><abstract>Hepatitis E virus (HEV) is implicated in many outbreaks of viral hepatitis in the Indian subcontinent. The conventional diagnosis of such outbreaks rests on the detection of anti‐HEV IgM antibodies. However, IgM antibodies develop after 4–5 days of infection. An early‐diagnostic marker is imperative for timely diagnosis of the outbreak and also initiation of control measures. This study aimed to determine the use of hepatitis E virus antigen detection as an early diagnostic marker in an outbreak in comparison to anti‐HEV IgM and RT‐PCR analyses. Forty samples were collected during a suspected outbreak of viral hepatitis due to HEV. A total of 36 samples were positive for one or more HEV markers. The positivity for anti‐HEV IgM, HEV antigen, and RT‐PCR was 91.6%, 69.4%, and 47.2% respectively. RT‐PCR and HEV antigen detection gave the highest positive results (100%) in the first 3 days of illness. Positive HEV PCR declined to 54% by Days 4–7, whereas HEV antigen and IgM detection were 88% and 100%, respectively. Sequencing of representative HEV samples indicated that the strains responsible for this outbreak belonged to genotype I, subtype 1a. HEV antigen was found to be an early diagnostic marker of acute infection. HEV antigen was detected in three additional cases in the early phase (1–3 days), and they had no detectable anti‐HEV IgM antibodies. These three samples were also positive for HEV RNA. After Day 7, anti‐HEV IgM was the main diagnostic indicator of infection. J. Med. Virol. 85:823–827, 2013. © 2013 Wiley Periodicals, Inc.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>23408566</pmid><doi>10.1002/jmv.23529</doi><tpages>5</tpages></addata></record> |
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| subjects | Adult Antigens Antigens, Viral - blood Biological and medical sciences Biomarkers Biomarkers - blood Disease Outbreaks ELISA Female Fundamental and applied biological sciences. Psychology Genotypes Hepatitis Hepatitis Antibodies - blood Hepatitis E - diagnosis Hepatitis E - epidemiology Hepatitis E virus Hepatitis E virus - isolation & purification HEV antigen Human viral diseases Humans Immunoglobulin M - blood India - epidemiology Infectious diseases Male Medical sciences Microbiology Middle Aged Miscellaneous Molecular Sequence Data outbreak outbreak, ELISA Reverse Transcriptase Polymerase Chain Reaction RNA, Viral - blood RNA, Viral - genetics Sensitivity and Specificity Sequence Analysis, DNA sequencing Time Factors Viral diseases Virology Young Adult |
| title | Hepatitis E virus antigen detection as an early diagnostic marker: Report from India |
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