Diagnostic utility of hepatitis E virus antigen-specific ELISA versus PCR testing in a cohort of post liver transplant patients in a large university hospital

G. Soothill, S. Hessey, M. Erotocritou, P. Griffiths, Samreen Ijaz, D. Thorburn, M. Ankcorn, D. Irish

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    4 Citations (Scopus)

    Abstract

    Background: Hepatitis E virus (HEV) is an important infectious agent causing acute and chronic disease. Chronic hepatitis E affects immunocompromised people and serological testing is neither reliable nor sufficient to infer whether a patient has infection; therefore HEV RNA testing is the only reliable diagnostic test presently available. An HEV antigen-specific ELISA test is commercially available but is not yet in clinical use. Objectives: 1) determine the prevalence of HEV infection in the Royal Free Hospital (RFH) liver transplant cohort; 2) compare the diagnostic utility of HEV antigen-detection against the current gold standard; 3) consider screening strategies for HEV infection in immunocompromised groups. Study design: The serum samples of 490 post liver transplant patients visiting the outpatient clinic at the RFH over an eight-month period were tested for HEV with both an HEV antigen-specific ELISA and HEV RNA test. Results: The prevalence of HEV infection was 0.20% (95% CI 0.0%–1.1%). The specificity of the ELISA was 98.2% with a positive predictive value of 10.0%. There was one true positive HEV case, which was picked up correctly by the antigen-specific ELISA. These results were improved by incorporating a neutralisation step into further ELISA tests. Conclusions: The antigen-specific ELISA test gave no false negative results, supporting its utility as a screening tool. There was one true antigen positive result. Further investigation including cost analysis is indicated to determine the efficacy of HEV antigen-specific ELISA testing in a screening context and in the clinical investigation of HEV infection in immunocompromised patients.

    Original languageEnglish
    Pages (from-to)44-48
    Number of pages5
    JournalJournal of Clinical Virology
    Volume106
    DOIs
    Publication statusPublished - Sep 2018

    Keywords

    • Antigen-specific ELISA
    • Hepatitis E virus
    • Liver transplant patients
    • Negative predictive value
    • Positive predictive value
    • Screening

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