Article ; Online: Serology versus nucleic acid amplification to diagnose acute hepatitis E, United Kingdom, 2014-18.
2022 Volume 85, Issue 3, Page(s) 327–333
Abstract: Objectives: Diagnosing hepatitis E infection usually involves specific IgM testing, but sensitivity/specificity concerns mean many guidelines and practices include confirmatory tests. We studied whether additional information confirmatory tests provide ... ...
Abstract | Objectives: Diagnosing hepatitis E infection usually involves specific IgM testing, but sensitivity/specificity concerns mean many guidelines and practices include confirmatory tests. We studied whether additional information confirmatory tests provide justifies their use. Methods: We examined 9131 records of anti-hepatitis E IgM assays, 7615 of IgG assays, and 1726 of RT-PCR assays from our regional laboratory, spanning October 2014-October 2018. We paired 495 IgM assay results with a RT-PCR result. We examined whether IgM results predicted PCR results, reviewed discrepant pairs, and investigated the correlation between IgG and PCR results in patients with strongly reactive IgM assays. Results: Anti-hepatitis E IgM titres are bimodal. A high cut-off value optimises prediction of RNA detectability. 7/404 low-IgM samples had detectable RNA, 6 from immunosuppressed patients. 26/91 high-IgM samples did not have detectable RNA. In high-IgM samples, RNA detectability was not associated with IgG titre (one-tailed Mann-Whitney U test, p = 0.14). Conclusions: In immunocompetent patients, tests beyond IgM seldom add clinically useful information. In patients with immunocompromise, IgM and RNA could contribute information. Additional tests' extra costs/intervention delays cannot be justified. IgM assay cut-offs should reflect titres' bimodal distribution, with values standardised using international units. |
---|---|
MeSH term(s) | Hepatitis Antibodies ; Hepatitis E/diagnosis ; Hepatitis E virus/genetics ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Nucleic Acids ; RNA ; RNA, Viral |
Chemical Substances | Hepatitis Antibodies ; Immunoglobulin G ; Immunoglobulin M ; Nucleic Acids ; RNA, Viral ; RNA (63231-63-0) |
Language | English |
Publishing date | 2022-06-23 |
Publishing country | England |
Document type | Journal Article ; Research Support, Non-U.S. Gov't |
ZDB-ID | 424417-5 |
ISSN | 1532-2742 ; 0163-4453 |
ISSN (online) | 1532-2742 |
ISSN | 0163-4453 |
DOI | 10.1016/j.jinf.2022.06.017 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
More links
Kategorien
In stock of ZB MED Cologne/Königswinter
Zs.A 1501: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG) |
|||
Zs.MG 48: Show issues |
Order via subito
This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.