Establishment of a Highly Sensitive Assay for Detection of Hepatitis E Virus-Specific Immunoglobulins

J Clin Microbiol. 2020 Jan 28;58(2):e01029-19. doi: 10.1128/JCM.01029-19. Print 2020 Jan 28.

Abstract

Hepatitis E, a liver disease caused by infection with the hepatitis E virus (HEV), is a worldwide emerging disease. The diagnosis is based on the detection of viral RNA and of HEV-specific immunoglobulins (Ig). For the latter, various assays are commercially available but still lack harmonization. In this study, a Luminex-based multiplex serological assay was established that measures the presence of total IgG, IgA, and IgM antibodies, targeting a short peptide derived from the viral E2 protein. For the validation, 160 serum samples with a known HEV serostatus were used to determine the assay cutoff and accuracy. Thereby, HEV IgG- and RNA-positive sera were identified with a sensitivity of 100% and a specificity of 98% (95% confidence interval [CI], 94% to 100%). Application of the assay by retesting 514 serum samples previously characterized with different HEV-IgG or total antibody tests revealed a high level of agreement between the assays (Cohen's kappa, 0.58 to 0.99). The established method is highly sensitive and specific and can be easily implemented in a multiplex format to facilitate rapid differential diagnostics with a few microliters of sample input.

Keywords: E2 antigen; S hepatitis E virus; anti-HEV immunoglobulins; antibody prevalence; multiplex assay.

Publication types

  • Validation Study

MeSH terms

  • Hepatitis Antibodies / blood*
  • Hepatitis Antigens / genetics
  • Hepatitis Antigens / immunology
  • Hepatitis E / diagnosis*
  • Hepatitis E / immunology
  • Hepatitis E virus
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin M / blood
  • Sensitivity and Specificity
  • Serologic Tests / methods*
  • Viral Envelope Proteins / genetics
  • Viral Envelope Proteins / immunology

Substances

  • Hepatitis Antibodies
  • Hepatitis Antigens
  • Immunoglobulin G
  • Immunoglobulin M
  • Viral Envelope Proteins