| Autor: |
El-Mokhtar MA; Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt.; Microbiology and Immunology Department, Faculty of Pharmacy, Sphinx University, Assiut, Egypt., Karam-Allah Ramadan H; Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut, Egypt., Abdel Hameed MR; Department of Internal Medicine and Hematology Unit, Assiut University Hospitals, Assiut University, Assiut, Egypt., M Kamel A; Microbiology and Immunology Department, Faculty of Pharmacy, Assiut University, Assiut Egypt., A Mandour S; Department of Microbiology and Immunology, Faculty of Pharmacy, Deraya University, Minia, Egypt., Ali M; Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Egypt., Abdel-Malek MAY; Department of Clinical Pathology, Faculty of Medicine, Assiut University, Egypt., M Abd El-Kareem D; Department of Clinical Pathology, Faculty of Medicine, Assiut University, Egypt., Adel S; Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt., H Salama E; Department of Clinical Pathology, Faculty of Medicine, Sohag University, Sohag, Egypt., Khalaf KAB; Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut, Egypt., Sayed IM; Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt.; Department of Pathology, School of Medicine, University of California, San Diego, La Jolla, California, USA. |
| Abstrakt: |
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. |
