Hepatitis E laboratory tests
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Varun Kumar, M.B.B.S. [2] João André Alves Silva, M.D. [3]
Overview
Laboratory Findings
Every patient with acute or chronic hepatitis, which cannot be explained by other causes, should be tested for hepatitis E.[1] Unfortunately, the different available assays show different specificity and sensitivity.[2]
Throughout the course of infection, serologic markers will vary according to the stage of the disease:[2]
- Incubation period - rise of viremia and detection of HEV in stool
- Symptom onset - IgM and IgG antibody detection, followed by elevations on serum aminotransferase and symptoms; HEV detected in stool
- Recovery - viral clearance; increase of IgG titers; decrease of IgM levels; HEV detected in stool during the initial period of recovery
The following tests are done to identify and monitor liver damage from hepatitis B:
- Albumin level
- Liver function tests
- Prothrombin time
- Antibody test
Since cases of hepatitis E are not clinically distinguishable from other types of acute viral hepatitis, diagnosis is made by blood tests which detect elevated antibody levels of specific antibodies to hepatitis E in the body or by reverse transcriptase polymerase chain reaction (RT-PCR). Unfortunately, such tests are not widely available.
Hepatitis E should be suspected in outbreaks of waterborne hepatitis occurring in developing countries, especially if the disease is more severe in pregnant women, or if hepatitis A has been excluded. If laboratory tests are not available, epidemiologic evidence can help in establishing a diagnosis.
References
- ↑ Wedemeyer H, Pischke S, Manns MP (2012). "Pathogenesis and treatment of hepatitis e virus infection". Gastroenterology. 142 (6): 1388–1397.e1. doi:10.1053/j.gastro.2012.02.014. PMID 22537448.
- ↑ 2.0 2.1 Hoofnagle JH, Nelson KE, Purcell RH (2012). "Hepatitis E." N Engl J Med. 367 (13): 1237–44. doi:10.1056/NEJMra1204512. PMID 23013075.