This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Herremans, M.
Right arrow Articles by Koopmans, M. P. G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Herremans, M.
Right arrow Articles by Koopmans, M. P. G.

 Previous Article  |  Next Article 

Clinical and Vaccine Immunology, May 2007, p. 562-568, Vol. 14, No. 5
1071-412X/07/$08.00+0     doi:10.1128/CVI.00231-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Use of Serological Assays for Diagnosis of Hepatitis E Virus Genotype 1 and 3 Infections in a Setting of Low Endemicity{triangledown}

M. Herremans,* J. Bakker, E. Duizer, H. Vennema, and M. P. G. Koopmans

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

Received 20 June 2006/ Returned for modification 7 October 2006/ Accepted 5 March 2007

Because of the occurrence of genotype 3 hepatitis E virus (HEV) in regions of low endemicity, it is important to validate the currently used serological assays for diagnosing infections with viruses belonging to this lineage, since these assays only use antigens derived from genotype 1 and 2 viruses. We evaluated the Genelabs enzyme-linked immunosorbent assay (ELISA) and the RecomBlot from Mikrogen for the detection of HEV-specific immunoglobulin M (IgM) and IgG under conditions of low endemicity. We compared test results of 16 patients with locally acquired genotype 3 HEV, 8 genotype 1 patients, 167 healthy controls from the general population, and 101 cases with hepatitis due to other viral causes. The measured specificities of the ELISA (98%) and the RecomBlot (97%) were comparable to those given by the manufacturer for IgM but were significantly lower for IgG (93% by ELISA and 66% by immunoblotting, versus reported values of 98% for ELISA and 95% for blotting). Antibody levels detected following infections with genotype 3 were lower than those following genotype 1 infections except for those measured in the IgM ELISA. Reactivity to the four antigens used in the immunoblot assay were analyzed and showed differences in the IgM immunoblot reactions between genotype 1 patients and genotype 3 patients. The ORF3 antigen was the most specific antigen. The specificity could be improved by a combined testing regimen with confirmation by immunoblotting of all positive ELISA results and by raising the cutoff of the IgG immunoblot assay without loss of sensitivity. We conclude that a combination of ELISA and immunoblotting is needed for acceptable specificity and sensitivity of HEV assays under conditions of low endemicity.

* 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 14 March 2007.

Clinical and Vaccine Immunology, May 2007, p. 562-568, Vol. 14, No. 5
1071-412X/07/$08.00+0     doi:10.1128/CVI.00231-06
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]  
  • Legrand-Abravanel, F., Thevenet, I., Mansuy, J.-M., Saune, K., Vischi, F., Peron, J.-M., Kamar, N., Rostaing, L., Izopet, J. (2009). Good Performance of Immunoglobulin M Assays in Diagnosing Genotype 3 Hepatitis E Virus Infections. CVI 16: 772-774 [Abstract] [Full Text]  
  • Galiana, C., Fernandez-Barredo, S., Garcia, A., Gomez, M. T., Perez-Gracia, M. T. (2008). Occupational Exposure to Hepatitis E Virus (HEV) in Swine Workers. Am J Trop Med Hyg 78: 1012-1015 [Abstract] [Full Text]  


Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»