Unexpected long‐lasting anti‐HEV IgM positivity: Is HEV antigen a better serological marker for hepatitis E infection diagnosis?
Hepatitis E virus (HEV) is the leading cause of acute hepatitis worldwide. The minimum criterion for diagnosis of acute infection is detection of anti‐HEV antibodies, although there are scant data on IgM duration. Our aim was to assess the persistence of HEV markers after acute self‐limited hepatiti...
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| Veröffentlicht in: | Journal of viral hepatitis 2020-07, Vol.27 (7), p.747-753 |
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| creator | Riveiro‐Barciela, Mar Rando‐Segura, Ariadna Barreira‐Díaz, Ana Bes, Marta P. Ruzo, Sofía Piron, Maria Quer, Josep Sauleda, Silvia Rodríguez‐Frías, Francisco Esteban, Rafael Buti, María |
| description | Hepatitis E virus (HEV) is the leading cause of acute hepatitis worldwide. The minimum criterion for diagnosis of acute infection is detection of anti‐HEV antibodies, although there are scant data on IgM duration. Our aim was to assess the persistence of HEV markers after acute self‐limited hepatitis E. HEV serological tests (IgM by Mikrogen and Wantai and HEV‐Ag) and HEV RNA were carried out in two cohorts: (a) patients with prior acute hepatitis E (ALT >10 x ULN plus positive IgM ± HEV RNA) currently self‐limited and (b) 50 blood donors with positive HEV RNA. Among 25 cases of prior acute hepatitis E, after a median follow‐up of 34 months, all presented undetectable HEV RNA. However, anti‐HEV IgM remained detectable in 14 (56%) by Mikrogen, 6 (24%) by Wantai and none for HEV‐Ag. Anti‐HEV IgM tested positive in 80%‐100% within the second year and 17%‐42% over 3 years later, by Wantai and Mikrogen, respectively. Among HEV RNA‐positive donors, 12 (25%) tested positive for either IgM by Mikrogen or Wantai, 9 (18%) for both and 18 (36%) for HEV‐Ag. HEV‐Ag positivity was more likely as HEV RNA was higher (14% if |
| doi_str_mv | 10.1111/jvh.13285 |
| format | Article |
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Ruzo, Sofía ; Piron, Maria ; Quer, Josep ; Sauleda, Silvia ; Rodríguez‐Frías, Francisco ; Esteban, Rafael ; Buti, María</creator><creatorcontrib>Riveiro‐Barciela, Mar ; Rando‐Segura, Ariadna ; Barreira‐Díaz, Ana ; Bes, Marta ; P. Ruzo, Sofía ; Piron, Maria ; Quer, Josep ; Sauleda, Silvia ; Rodríguez‐Frías, Francisco ; Esteban, Rafael ; Buti, María</creatorcontrib><description>Hepatitis E virus (HEV) is the leading cause of acute hepatitis worldwide. The minimum criterion for diagnosis of acute infection is detection of anti‐HEV antibodies, although there are scant data on IgM duration. Our aim was to assess the persistence of HEV markers after acute self‐limited hepatitis E. HEV serological tests (IgM by Mikrogen and Wantai and HEV‐Ag) and HEV RNA were carried out in two cohorts: (a) patients with prior acute hepatitis E (ALT >10 x ULN plus positive IgM ± HEV RNA) currently self‐limited and (b) 50 blood donors with positive HEV RNA. Among 25 cases of prior acute hepatitis E, after a median follow‐up of 34 months, all presented undetectable HEV RNA. However, anti‐HEV IgM remained detectable in 14 (56%) by Mikrogen, 6 (24%) by Wantai and none for HEV‐Ag. Anti‐HEV IgM tested positive in 80%‐100% within the second year and 17%‐42% over 3 years later, by Wantai and Mikrogen, respectively. Among HEV RNA‐positive donors, 12 (25%) tested positive for either IgM by Mikrogen or Wantai, 9 (18%) for both and 18 (36%) for HEV‐Ag. HEV‐Ag positivity was more likely as HEV RNA was higher (14% if <2.2 log IU/mL; 64% if RNA ≥ 3.7). Overall, HEV‐Ag performed best, with a positive predictive value of 100% and diagnostic accuracy of 57%. Anti‐HEV IgM exhibited unexpectedly long persistence after a self‐limited acute hepatitis E. HEV‐Ag had the best performance and could be especially useful in settings where HEV RNA is not available.</description><identifier>ISSN: 1352-0504</identifier><identifier>EISSN: 1365-2893</identifier><identifier>DOI: 10.1111/jvh.13285</identifier><identifier>PMID: 32106351</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>anti‐HEV IgM Mikrogen ; anti‐HEV IgM Wantai ; Blood donors ; Diagnosis ; Hepatitis ; hepatitis E virus ; HEV antigen ; Immunoglobulin M ; Ribonucleic acid ; RNA ; Serological tests ; Serology</subject><ispartof>Journal of viral hepatitis, 2020-07, Vol.27 (7), p.747-753</ispartof><rights>2020 John Wiley & Sons Ltd</rights><rights>2020 John Wiley & Sons Ltd.</rights><rights>Copyright © 2020 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3535-85c5b552294b276be48f9d2e27a01161c17cb4b154186eb14e5ac3d00c9db5c13</citedby><cites>FETCH-LOGICAL-c3535-85c5b552294b276be48f9d2e27a01161c17cb4b154186eb14e5ac3d00c9db5c13</cites><orcidid>0000-0001-9309-2052 ; 0000-0003-0014-084X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjvh.13285$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjvh.13285$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32106351$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Riveiro‐Barciela, Mar</creatorcontrib><creatorcontrib>Rando‐Segura, Ariadna</creatorcontrib><creatorcontrib>Barreira‐Díaz, Ana</creatorcontrib><creatorcontrib>Bes, Marta</creatorcontrib><creatorcontrib>P. Ruzo, Sofía</creatorcontrib><creatorcontrib>Piron, Maria</creatorcontrib><creatorcontrib>Quer, Josep</creatorcontrib><creatorcontrib>Sauleda, Silvia</creatorcontrib><creatorcontrib>Rodríguez‐Frías, Francisco</creatorcontrib><creatorcontrib>Esteban, Rafael</creatorcontrib><creatorcontrib>Buti, María</creatorcontrib><title>Unexpected long‐lasting anti‐HEV IgM positivity: Is HEV antigen a better serological marker for hepatitis E infection diagnosis?</title><title>Journal of viral hepatitis</title><addtitle>J Viral Hepat</addtitle><description>Hepatitis E virus (HEV) is the leading cause of acute hepatitis worldwide. The minimum criterion for diagnosis of acute infection is detection of anti‐HEV antibodies, although there are scant data on IgM duration. Our aim was to assess the persistence of HEV markers after acute self‐limited hepatitis E. HEV serological tests (IgM by Mikrogen and Wantai and HEV‐Ag) and HEV RNA were carried out in two cohorts: (a) patients with prior acute hepatitis E (ALT >10 x ULN plus positive IgM ± HEV RNA) currently self‐limited and (b) 50 blood donors with positive HEV RNA. Among 25 cases of prior acute hepatitis E, after a median follow‐up of 34 months, all presented undetectable HEV RNA. However, anti‐HEV IgM remained detectable in 14 (56%) by Mikrogen, 6 (24%) by Wantai and none for HEV‐Ag. Anti‐HEV IgM tested positive in 80%‐100% within the second year and 17%‐42% over 3 years later, by Wantai and Mikrogen, respectively. Among HEV RNA‐positive donors, 12 (25%) tested positive for either IgM by Mikrogen or Wantai, 9 (18%) for both and 18 (36%) for HEV‐Ag. HEV‐Ag positivity was more likely as HEV RNA was higher (14% if <2.2 log IU/mL; 64% if RNA ≥ 3.7). Overall, HEV‐Ag performed best, with a positive predictive value of 100% and diagnostic accuracy of 57%. Anti‐HEV IgM exhibited unexpectedly long persistence after a self‐limited acute hepatitis E. HEV‐Ag had the best performance and could be especially useful in settings where HEV RNA is not available.</description><subject>anti‐HEV IgM Mikrogen</subject><subject>anti‐HEV IgM Wantai</subject><subject>Blood donors</subject><subject>Diagnosis</subject><subject>Hepatitis</subject><subject>hepatitis E virus</subject><subject>HEV antigen</subject><subject>Immunoglobulin M</subject><subject>Ribonucleic acid</subject><subject>RNA</subject><subject>Serological tests</subject><subject>Serology</subject><issn>1352-0504</issn><issn>1365-2893</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kUFvFCEUx4mxsbV68AsYEi96mJYHw-yMF2Oa1d2mxovtlTDMmynrLEyBre7Ngx_Az9hPUtatHkzkArz8-D3gT8gLYCeQx-nq9voEBK_lI3IEopIFrxvxeLeWvGCSlYfkaYwrxjIk4Qk5FBxYJSQckZ-XDr9PaBJ2dPRuuPvxa9QxWTdQ7ZLN28X8ii6HT3Ty0SZ7a9P2LV1GuivviAEd1bTFlDDQiMGPfrBGj3Stw9dc6n2g1zjplA9HOqfW9bmb9Y52Vg8uS-O7Z-Sg12PE5w_zMbn8MP9ytiguPn9cnr2_KIyQQha1NLKVkvOmbPmsarGs-6bjyGeaAVRgYGbasgVZQl1hCyVKbUTHmGm6VhoQx-T13jsFf7PBmNTaRoPjqB36TVRcVE3JeQV1Rl_9g678Jrh8O8VL4HX-v3qWqTd7ygQfY8BeTcHmh28VMLWLRuVo1O9oMvvywbhp19j9Jf9kkYHTPfDNjrj9v0mdXy32yntqqZna</recordid><startdate>202007</startdate><enddate>202007</enddate><creator>Riveiro‐Barciela, Mar</creator><creator>Rando‐Segura, Ariadna</creator><creator>Barreira‐Díaz, Ana</creator><creator>Bes, Marta</creator><creator>P. Ruzo, Sofía</creator><creator>Piron, Maria</creator><creator>Quer, Josep</creator><creator>Sauleda, Silvia</creator><creator>Rodríguez‐Frías, Francisco</creator><creator>Esteban, Rafael</creator><creator>Buti, María</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9309-2052</orcidid><orcidid>https://orcid.org/0000-0003-0014-084X</orcidid></search><sort><creationdate>202007</creationdate><title>Unexpected long‐lasting anti‐HEV IgM positivity: Is HEV antigen a better serological marker for hepatitis E infection diagnosis?</title><author>Riveiro‐Barciela, Mar ; Rando‐Segura, Ariadna ; Barreira‐Díaz, Ana ; Bes, Marta ; P. Ruzo, Sofía ; Piron, Maria ; Quer, Josep ; Sauleda, Silvia ; Rodríguez‐Frías, Francisco ; Esteban, Rafael ; Buti, María</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3535-85c5b552294b276be48f9d2e27a01161c17cb4b154186eb14e5ac3d00c9db5c13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>anti‐HEV IgM Mikrogen</topic><topic>anti‐HEV IgM Wantai</topic><topic>Blood donors</topic><topic>Diagnosis</topic><topic>Hepatitis</topic><topic>hepatitis E virus</topic><topic>HEV antigen</topic><topic>Immunoglobulin M</topic><topic>Ribonucleic acid</topic><topic>RNA</topic><topic>Serological tests</topic><topic>Serology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Riveiro‐Barciela, Mar</creatorcontrib><creatorcontrib>Rando‐Segura, Ariadna</creatorcontrib><creatorcontrib>Barreira‐Díaz, Ana</creatorcontrib><creatorcontrib>Bes, Marta</creatorcontrib><creatorcontrib>P. Ruzo, Sofía</creatorcontrib><creatorcontrib>Piron, Maria</creatorcontrib><creatorcontrib>Quer, Josep</creatorcontrib><creatorcontrib>Sauleda, Silvia</creatorcontrib><creatorcontrib>Rodríguez‐Frías, Francisco</creatorcontrib><creatorcontrib>Esteban, Rafael</creatorcontrib><creatorcontrib>Buti, María</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of viral hepatitis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Riveiro‐Barciela, Mar</au><au>Rando‐Segura, Ariadna</au><au>Barreira‐Díaz, Ana</au><au>Bes, Marta</au><au>P. Ruzo, Sofía</au><au>Piron, Maria</au><au>Quer, Josep</au><au>Sauleda, Silvia</au><au>Rodríguez‐Frías, Francisco</au><au>Esteban, Rafael</au><au>Buti, María</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Unexpected long‐lasting anti‐HEV IgM positivity: Is HEV antigen a better serological marker for hepatitis E infection diagnosis?</atitle><jtitle>Journal of viral hepatitis</jtitle><addtitle>J Viral Hepat</addtitle><date>2020-07</date><risdate>2020</risdate><volume>27</volume><issue>7</issue><spage>747</spage><epage>753</epage><pages>747-753</pages><issn>1352-0504</issn><eissn>1365-2893</eissn><abstract>Hepatitis E virus (HEV) is the leading cause of acute hepatitis worldwide. The minimum criterion for diagnosis of acute infection is detection of anti‐HEV antibodies, although there are scant data on IgM duration. Our aim was to assess the persistence of HEV markers after acute self‐limited hepatitis E. HEV serological tests (IgM by Mikrogen and Wantai and HEV‐Ag) and HEV RNA were carried out in two cohorts: (a) patients with prior acute hepatitis E (ALT >10 x ULN plus positive IgM ± HEV RNA) currently self‐limited and (b) 50 blood donors with positive HEV RNA. Among 25 cases of prior acute hepatitis E, after a median follow‐up of 34 months, all presented undetectable HEV RNA. However, anti‐HEV IgM remained detectable in 14 (56%) by Mikrogen, 6 (24%) by Wantai and none for HEV‐Ag. Anti‐HEV IgM tested positive in 80%‐100% within the second year and 17%‐42% over 3 years later, by Wantai and Mikrogen, respectively. Among HEV RNA‐positive donors, 12 (25%) tested positive for either IgM by Mikrogen or Wantai, 9 (18%) for both and 18 (36%) for HEV‐Ag. HEV‐Ag positivity was more likely as HEV RNA was higher (14% if <2.2 log IU/mL; 64% if RNA ≥ 3.7). Overall, HEV‐Ag performed best, with a positive predictive value of 100% and diagnostic accuracy of 57%. Anti‐HEV IgM exhibited unexpectedly long persistence after a self‐limited acute hepatitis E. HEV‐Ag had the best performance and could be especially useful in settings where HEV RNA is not available.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32106351</pmid><doi>10.1111/jvh.13285</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-9309-2052</orcidid><orcidid>https://orcid.org/0000-0003-0014-084X</orcidid></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | anti‐HEV IgM Mikrogen anti‐HEV IgM Wantai Blood donors Diagnosis Hepatitis hepatitis E virus HEV antigen Immunoglobulin M Ribonucleic acid RNA Serological tests Serology |
| title | Unexpected long‐lasting anti‐HEV IgM positivity: Is HEV antigen a better serological marker for hepatitis E infection diagnosis? |
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