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

Simultaneous Detection of Immunoglobulin A (IgA) and IgM Antibodies against Hepatitis E Virus (HEV) Is Highly Specific for Diagnosis of Acute HEV Infection

Division of Virology, Department of Infection and Immunity, Jichi Medical School, Tochigi-Ken,¹ Institute of Immunology, Tokyo,² Department of Internal Medicine, Kin-ikyo Chuo Hospital, Hokkaido,³ First Department of Internal Medicine, Iwate Medical University, Iwate-Ken,⁴ Japanese Red Cross Yamaguchi Blood Center, Yamaguchi-Ken,⁵ Masuko Memorial Hospital and Masuko Institute for Medical Research, Aichi-Ken,⁶ Department of Internal Medicine, Iwaki Kyoritsu General Hospital, Fukushima-Ken,⁷ Aikawa Internal Medicine Hospital, Ibaraki-Ken, Japan⁸

Received 3 July 2004/ Returned for modification 21 September 2004/ Accepted 29 September 2004

Serum samples collected from 68 patients (age, mean ± the standard deviation [SD], 56.3 ± 12.8 years) at admission who were subsequently molecularly diagnosed as having hepatitis E and from 2,781 individuals who were assumed not to have been recently infected with hepatitis E virus (HEV; negative controls; 52.9 ± 18.9 years), were tested for immunoglobulin M (IgM) and IgA classes of antibodies to HEV (anti-HEV) by in-house solid-phase enzyme immunoassay with recombinant open reading frame 2 protein expressed in the pupae of silkworm as the antigen probe. The 68 patients with hepatitis E had both anti-HEV IgM and anti-HEV IgA. Among the 2,781 controls, 16 (0.6%) had anti-HEV IgM alone and 4 (0.1%) had anti-HEV IgA alone: these IgA/IgM anti-HEV-positive individuals were not only negative for HEV RNA but lack IgG anti-HEV antibody as well (at least in most of the cases). Periodic serum samples obtained from 15 patients with hepatitis E were tested for HEV RNA, anti-HEV IgM, and anti-HEV IgA. Although HEV RNA was detectable in the serum until 7 to 40 (21.4 ± 9.7) days after disease onset, both IgM and IgA anti-HEV antibodies were detectable until 37, 55, or 62 days after disease onset in three patients and up through the end of the observation period (50 to 144 days) in 12 patients. These results indicate that detection of anti-HEV IgA alone or along with anti-HEV IgM is useful for serological diagnosis of hepatitis E with increased specificity and longer duration of positivity than that by RNA detection.

This article has been cited by other articles:

• Takahashi, M., Tanaka, T., Azuma, M., Kusano, E., Aikawa, T., Shibayama, T., Yazaki, Y., Mizuo, H., Inoue, J., Okamoto, H. (2007). Prolonged Fecal Shedding of Hepatitis E Virus (HEV) during Sporadic Acute Hepatitis E: Evaluation of Infectivity of HEV in Fecal Specimens in a Cell Culture System. J. Clin. Microbiol. 45: 3671-3679 [Abstract] [Full Text]  
• Tanaka, T., Takahashi, M., Kusano, E., Okamoto, H. (2007). Development and evaluation of an efficient cell-culture system for Hepatitis E virus. J. Gen. Virol. 88: 903-911 [Abstract] [Full Text]  
• Herremans, M., Duizer, E., Jusic, E., Koopmans, M. P. G. (2007). Detection of Hepatitis E Virus-Specific Immunoglobulin A in Patients Infected with Hepatitis E Virus Genotype 1 or 3. CVI 14: 276-280 [Abstract] [Full Text]  
• Inoue, J., Takahashi, M., Ito, K., Shimosegawa, T., Okamoto, H. (2006). Analysis of human and swine hepatitis E virus (HEV) isolates of genotype 3 in Japan that are only 81-83 % similar to reported HEV isolates of the same genotype over the entire genome.. J. Gen. Virol. 87: 2363-2369 [Abstract] [Full Text]  
• Myint, K. S. A., Endy, T. P., Gibbons, R. V., Laras, K., Mammen, M. P. Jr., Sedyaningsih, E. R., Seriwatana, J., Glass, J. S., Narupiti, S., Corwin, A. L. (2006). Evaluation of Diagnostic Assays for Hepatitis E Virus in Outbreak Settings. J. Clin. Microbiol. 44: 1581-1583 [Abstract] [Full Text]  
• Takahashi, M., Nishizawa, T., Tanaka, T., Tsatsralt-Od, B., Inoue, J., Okamoto, H. (2005). Correlation between positivity for immunoglobulin A antibodies and viraemia of swine hepatitis E virus observed among farm pigs in Japan. J. Gen. Virol. 86: 1807-1813 [Abstract] [Full Text]