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Clinical and Vaccine Immunology, March 2007, p. 276-280, Vol. 14, No. 3
1071-412X/07/$08.00+0     doi:10.1128/CVI.00312-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Detection of Hepatitis E Virus-Specific Immunoglobulin A in Patients Infected with Hepatitis E Virus Genotype 1 or 3{triangledown}

M. Herremans,* E. Duizer, E. Jusic, and M. P. G. Koopmans

National Institute for Public Health and the Environment, Diagnostic Laboratory for Infectious Diseases and Perinatal Screening, Bilthoven, The Netherlands

Received 30 August 2006/ Returned for modification 11 November 2006/ Accepted 18 January 2007

Currently, diagnosis of acute hepatitis E virus (HEV) in patients is primarily based on anti-HEV immunoglobulin M (IgM) detection. However, several investigations suggest the use of HEV-specific IgA for diagnosing acute HEV infections. We evaluated two commercially available assays, an IgA enzyme-linked immunosorbent assay (ELISA) (Diacheck) and an adapted immunoblot protocol (Mikrogen) for IgA detection and compared the performance in genotype 1- and 3-infected patients. The specificity of the IgA assays was high, with no positive reactions in a control group of 18 acute hepatitis patients who were negative for HEV. The sensitivity calculated in nine PCR-positive type 1-infected patients was 100% in both assays but was clearly lower in genotype 3-infected patients (n = 14), with sensitivities of only 67% and 57% for the ELISA and immunoblot assay, respectively. The lower IgA responses detected in genotype 3-infected patients could be caused by the use of only the genotype 1 and 2 antigens in the serological assays. Interestingly in two patients with possible infection through blood transfusion no response or intermediate IgA responses were detected, and this might confirm the parenteral route of transmission. In both the type 1- and type 3-infected patients both the IgA and IgM responses disappeared simultaneously. We conclude that IgA detection is of limited value for the serodiagnosis of acute HEV cases, particularly with genotype 3.

* Corresponding author. Mailing address: P.O. Box 1, 3720 BA Bilthoven, The Netherlands. Phone: 31-302743705. Fax: 31-302744418. E-mail: Tineke.Herremans{at}rivm.nl.

{triangledown} Published ahead of print on 31 January 2007.

Clinical and Vaccine Immunology, March 2007, p. 276-280, Vol. 14, No. 3
1071-412X/07/$08.00+0     doi:10.1128/CVI.00312-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Jimenez de Oya, N., Galindo, I., Girones, O., Duizer, E., Escribano, J. M., Saiz, J.-C. (2009). Serological Immunoassay for Detection of Hepatitis E Virus on the Basis of Genotype 3 Open Reading Frame 2 Recombinant Proteins Produced in Trichoplusia ni Larvae. J. Clin. Microbiol. 47: 3276-3282 [Abstract] [Full Text]  


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