Artikel ; Online: Serology versus nucleic acid amplification to diagnose acute hepatitis E, United Kingdom, 2014-18.
2022 Band 85, Heft 3, Seite(n) 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. |
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Mesh-Begriff(e) | Hepatitis Antibodies ; Hepatitis E/diagnosis ; Hepatitis E virus/genetics ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Nucleic Acids ; RNA ; RNA, Viral |
Chemische Substanzen | Hepatitis Antibodies ; Immunoglobulin G ; Immunoglobulin M ; Nucleic Acids ; RNA, Viral ; RNA (63231-63-0) |
Sprache | Englisch |
Erscheinungsdatum | 2022-06-23 |
Erscheinungsland | England |
Dokumenttyp | 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 |
Datenquelle | MEDical Literature Analysis and Retrieval System OnLINE |
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