Short communicationDiscrepancy between anti-hepatitis E virus immunoglobulin G prevalence assessed by two assays in kidney and liver transplant recipients
Section snippets
Background
Hepatitis E virus (HEV) is an emerging clinical threat in Europe among kidney and liver-transplant recipients. Thus, >50% of infections turn chronic and subsequent rapid cirrhosis has been described.1, 2 Incidence and prevalence of HEV infection in this special population are poorly known. The rate of previous exposure has been tentatively assessed through anti-HEV IgG testing and was ≈4%.3, 4 However, a long-lasting considerable distrust exists regarding anti-HEV microplate enzyme-immuno
Objectives
We compared anti-HEV IgG and IgM prevalence using two different commercial MEIAs including Wantai assays in 64 solid organ transplant recipients.
Study design
Patients studied were 50 kidney-transplant, 12 liver-transplant, and 2 kidney- and liver-transplant recipients for whom serum collected over the 12/2009–12/2011 period has been tested for anti-HEV IgG and IgM in our routine clinical practice with Adaltis MEIAs (EIAgen, Adaltis, Casalecchio Di Reno, Italy). These serum samples were retrospectively tested using Wantai MEIAs (Wantai Biologic Pharmacy Enterprise, Beijing, People's Republic of China). Tests were performed according to manufacturers’
Results
Comparative analysis of anti-HEV IgG results on the 64 serum samples showed 7 positive results (10.9%) and one ‘gray zone’ result with Adaltis MEIA versus 20 positive results (31.3%) and three ‘gray zone’ results with Wantai assay (p = 0.005; Table 1). Thus, prevalence was 2.9 times higher when assessed by Wantai compared to Adaltis. The two assays were concordant for only 77% (49/64) of serum samples. Regarding positive results, mean SCR was 5.5 ± 4.7 (range, 1.2–10.6) with Adaltis assay and 8.2 ±
Discussion
Reliable assessment of HEV exposure is influential in improving our knowledge on HEV epidemiology, identifying sources and routes of HEV transmission, studying duration of protection post-HEV exposure, or diagnosing HEV reactivation. This is particularly important among kidney-/liver-transplant recipients in whom HEV infection is a considerable clinical concern.1, 2, 13 Present findings indicate that anti-HEV IgG prevalence is high in kidney/liver-transplant recipients in our geographical area
Funding
None for all authors.
Competing interest
None for all authors.
Ethical approval
None required.
Acknowledgement
None.
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