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Laboratory Diagnosis of HEV Infection

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Hepatitis E Virus

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1417))

Abstract

Serological and nucleic acid tests for detecting hepatitis E virus (HEV) have been developed for both epidemiologic and diagnostic purposes. The laboratory diagnosis of HEV infection depends on the detection of HEV antigen or HEV RNA in the blood, stool, and other body fluids, and serum antibodies against HEV (immunoglobulin [Ig]A, IgM, and IgG). Anti-HEV IgM antibodies and low avidity IgG can be detected during the acute phase of the illness and can last approximately 12 months, representing primary infection, whereas anti-HEV IgG antibodies can last more than several years, representing remote exposure. Thus, the diagnosis of acute infection is based on the presence of anti-HEV IgM, low avidity IgG, HEV antigen, and HEV RNA, while epidemiological investigations are mainly based on anti-HEV IgG. Although significant progress has been made in developing and optimizing different formats of HEV assays, improving their sensitivity and specificity, there are many shortcomings and challenges in inter-assay concordance, validation, and standardization. This article reviews the current knowledge on the diagnosis of HEV infection, including the most common available laboratory diagnostic techniques.

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Abbreviations

ALF:

Acute liver failure

ALP:

Alkaline phosphatase

ALT:

Alanine aminotransferase

AST:

Aspartate aminotransferase

EASL:

The European Association for the Study of the Liver

EIA:

Enzyme immunoassay

GGT:

γ-glutamyl transferase

HEV:

Hepatitis E Virus

IgA:

Immunoglobulin A

IgG:

Immunoglobulin G

IgM:

Immunoglobulin M

IS:

International Standard

NAT:

Nucleic acid amplification technology

ORF:

Open reading frame

TBA:

Total iron binding capacity

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Authors and Affiliations

  1. Division of HIV/AIDS and Sex-Transmitted Virus Vaccines, National Institutes for Food and Drug Control, Beijing, China

    Chenyan Zhao

  2. Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China

    Youchun Wang

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  1. Chenyan Zhao
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  2. Youchun Wang
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Correspondence to Youchun Wang .

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  1. Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China

    Youchun Wang

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Zhao, C., Wang, Y. (2023). Laboratory Diagnosis of HEV Infection. In: Wang, Y. (eds) Hepatitis E Virus. Advances in Experimental Medicine and Biology, vol 1417. Springer, Singapore. https://doi.org/10.1007/978-981-99-1304-6_14

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