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Semin Liver Dis 2013; 33(01): 030-040
DOI: 10.1055/s-0033-1338112
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Hepatitis E: Clinical Presentation in Disease-Endemic Areas and Diagnosis

Rakesh A. Aggarwal
1   Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Publikationsdatum:
05. April 2013 (online)

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Erratum zu diesem Artikel:

Hepatitis E: Clinical Presentation in Disease-Endemic Areas and DiagnosisSemin Liver Dis 2013; 33(02): 185-186
DOI: 10.1055/s-0033-1345723

Abstract

Infection with hepatitis E virus (HEV), mostly genotype 1, is endemic in several developing countries. It can be asymptomatic, be associated with acute hepatitis or fulminant hepatic failure, or present as acute-on-chronic liver disease. Pregnant women are at particular risk of serious outcomes and death. Chronic HEV infection has not been reported from these areas.

Diagnosis of acute hepatitis E depends on detection of IgM anti-HEV antibodies or HEV RNA. Current assays for IgM anti-HEV are suboptimal, with high rates of interassay discordance. Though they perform reasonably well in disease-endemic areas, positive test results in low-endemicity areas require confirmation using HEV RNA testing. Detection of IgG anti-HEV antibodies indicates exposure to HEV, either recent or remote. Assays for these too have low concordance, making comparisons of seroprevalence rates using different assays difficult to interpret. There is an urgent need to develop better assays for markers of HEV infection and exposure.

Keywords

hepatitis E - HEV - clinical manifestations - diagnosis - immunoassays - anti-HEV antibodies
 

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