Evaluation of hepatitis E antigen kinetics and its diagnostic utility for prediction of the outcomes of hepatitis E virus genotype 1 infection

Autor: Mohamed A. El-Mokhtar, Haidi Karam-Allah Ramadan, Muhamad R. Abdel Hameed, Ayat M. Kamel, Sahar A. Mandour, Maha Ali, Mohamed A. Y. Abdel-Malek, Doaa M. Abd El-Kareem, Sara Adel, Eman H. Salama, Khaled Abo Bakr Khalaf, Ibrahim M. Sayed
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Virulence, Vol 12, Iss 1, Pp 1334-1344 (2021)
Druh dokumentu: article
ISSN: 2150-5594
2150-5608
21505594
DOI: 10.1080/21505594.2021.1922027
Popis: 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 we 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.
Databáze: Directory of Open Access Journals
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