Diagnostic value of immunoglobulin G (IgG) and IgM anti-hepatitis E virus (HEV) tests based on HEV RNA in an area where hepatitis E is not endemic

Acute hepatitis E (AHE) has rarely been reported in industrialized countrie s, but the rate of seroprevalence of hepatitis E virus (HEV) antibodies (an ti-HEV) is inappropriately high. The sensitivity and specificity of the ass ay used to test for immunoglobulin G (IgG) and IgM anti-HEV have not been w ell established in areas where hepatitis E is not endemic thereafter referr ed to as "nonendemic areas"). We collected serum samples from 13 AHE patien ts, 271 healthy subjects, and 160 other liver disease patients in Taiwan to test for HEV RNA by reverse transcription (RT)-PCR and for Ige and IgM ant i-HEV by enzyme-linked immunosorbent assays. The sensitivities of IgG and I gM anti-HEV (relative to RT-PCR) were 86.7 and 53.3%, respectively. The spe cificities of IgG and IgM anti-HEV assays for diagnosing AHE were 92.1 and 98.6%, respectively. The rate of seroprevalence of IgG anti-HEV was 11% amo ng healthy subjects in this nonendemic area, and it increased with age. In summary, IgG anti-HEV is a good diagnostic test for screening for AHE in no nendemic areas. The high rate of prevalence of anti-HEV in healthy subjects indicates that subclinical infection may exist.