Evaluation of hepatitis E antigen kinetics and its diagnostic utility for prediction of the outcomes of hepatitis E virus genotype 1 infection. Issue 1 (1st January 2021)

• Record Type: Journal Article
• Authors: El-Mokhtar, Mohamed A.; Karam-Allah Ramadan, Haidi; Abdel Hameed, Muhamad R.; M. Kamel, Ayat; A. Mandour, Sahar; Ali, Maha; Abdel-Malek, Mohamed A. Y.; M. Abd El-Kareem, Doaa; Adel, Sara; H. Salama, Eman; Khalaf, Khaled Abo Bakr; Sayed, Ibrahim M.
• Is Part Of: Virulence. Volume 12:Issue 1(2021)
• Page Start: 1334
• Page End: 1344
• Publication Date: 2021-01-01
• Subjects: HEV antigen -- HEV genotype 1 -- acute self-limiting infection -- fulminant hepatic failure -- HEV kinetic -- predictive biomarker; Virulence (Microbiology) -- Periodicals; Bacterial diseases -- Periodicals; Molecular microbiology -- Periodicals; 579.05
• DOI: 10.1080/21505594.2021.1922027
• Languages: English
• ISSNs: 2150-5608

Abstract

ABSTRACT: HEV-Ag ELISA assay is a reliable diagnostic test in resource-limited areas. HEV genotype 1 (HEV-1) infections are either self-limited or progress to fulminant hepatic failure (FHF) and death if anti-HEV therapy is delayed. Limited data is available about the diagnostic utility of HEV Ag on HEV-1 infections. Herein wWe aimed to study the kinetics of HEV Ag during HEV-1 infections at different stages, i.e., acute HEV infection, recovery, and progression to FHF. Also, we evaluated the diagnostic utility of this marker to predict the outcomes of HEV-1 infections. Plasma of acute hepatitis E (AHE) patients were assessed for HEV RNA by RT-qPCR, HEV Ag, and anti-HEV IgM by ELISA. The kinetics of HEV Ag was monitored at different time points; acute phase of infection, recovery, FHF stage, and post-recovery. Our results showed that the level of HEV Ag was elevated in AHE patients with a significantly higher level in FHF patients than recovered patients. We identified a plasma HEV Ag threshold that can differentiate between self-limiting infection and FHF progression with 100% sensitivity and 88.89% specificity. HEV Ag and HEV RNA have similar kinetics during the acute phase and self-limiting infection. In the FHF stage, HEV Ag and anti-HEV IgM have similar patterns of kinetics which could be the cause of liver damage. In conclusion, the HEV Ag assay can be used as a biomarker for predicting the consequences of HEV-1 infections which could be diagnostically useful for taking the appropriate measures to reduce the complications, especially for high-risk groups.