1. Evaluation of hepatitis E antigen kinetics and its diagnostic utility for prediction of the outcomes of hepatitis E virus genotype 1 infection
- Author
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Mohamed A. Y. Abdel-Malek, Eman H Salama, Maha Ali, Muhamad R. Abdel Hameed, Mohamed A El-Mokhtar, Ibrahim M Sayed, Ayat M. Kamel, Khaled Abo Bakr Khalaf, Doaa M. Abd El-Kareem, Haidi Karam-Allah Ramadan, Sahar A. Mandour, and Sara Adel
- Subjects
Microbiology (medical) ,Genotype ,viruses ,Immunology ,hev kinetic ,Infectious and parasitic diseases ,RC109-216 ,Biology ,Microbiology ,03 medical and health sciences ,Fulminant hepatic failure ,Hepatitis E virus ,Humans ,Hepatitis Antibodies ,Liver damage ,predictive biomarker ,hev genotype 1 ,030304 developmental biology ,0303 health sciences ,030306 microbiology ,Acute hepatitis E ,Hepatitis Antigens ,Hepatitis E virus genotype ,virus diseases ,Elisa assay ,digestive system diseases ,Hepatitis E ,hev antigen ,Kinetics ,Infectious Diseases ,Immunoglobulin M ,Hepatitis E antigen ,RNA, Viral ,Biomarker (medicine) ,Parasitology ,acute self-limiting infection ,Biomarkers ,Research Article ,Research Paper ,fulminant hepatic failure - 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.
- Published
- 2021