CONSECUTIVE EVALUATION OF IMMUNOGLOBULIN-M AND IMMUNOGLOBULIN-G ANTIBODIES AGAINST HEPATITIS-E VIRUS

Hepatitis E virus (HEV) infection is sporadic in the Guangzhou city so uthern China, However, the evaluation of antibodies to HEV during cons ecutive time periods after infection has not been reported. We utilize d enzyme immunosorbent assay (ELISA) to detect IgM and IgG anti-HEV in consecutive serum specimens from patients with acute hepatitis E and compared that data with detection rates of IgM and IgG anti-HAV in pat ients with acute hepatitis A. IgM anti-HEV can be detected as early as 4 days after onset of disease symptoms in some patients. The detectio n rate of IgM anti-HEV is significantly higher in specimens collected within 4 weeks (95%) of onset than in those specimens collected 4 to 1 8 weeks after onset (67.6%) (P < 0.005). IgM anti-HEV had a similar pa ttern to IgM anti-HAV and can be used as a marker of acute HEV infecti on. In contrast with IgG anti-HAV, 56.8% of the specimens did not cont ain detectable levels of IgG anti-HEV (P < 0.005). One-should be cauti oned against making a diagnosis of HEV infection solely by the current ly available assays for IgG anti-HEV. In conclusion, IgM anti-HEV can be used as a reliable and sensitive marker for recent HEV infection, b ut serum specimens should be collected within 4 weeks after onset of s ymptoms to avoid false-negative results. In contrast, we should be awa re of the failure to develop IgG anti-HEV in some patients. These pati ents carry the risk of reinfection.