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Abstract |
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Acute Hepatitis E. virus infection in Osman*, F, Abu-Shady**, EA,
Abd El-Wahab**, KSE, El-Rashidy**, ZE, Microbiology Department, Faculty of Medicine – Abstract
Hepatitis E virus (HEV) is largely responsible for water borne
epidemics in many developing countries. The principle mode of HEV
transmission is the fecal oral route in epidemic and sporadic forms with a
high case fatality ratio in pregnant women. Serum samples from 50 healthy
subjects and from 435 acute viral hepatitis patients, 4-75 years old, were
screened for markers of acute viral hepatitis. These included (HBsAg,
anti-HBc (IgM), anti-HDV (IgM), HAV (IgM), anti-HCV (IgG), and anti-HEV
(IgG), and (IgM) tests by enzyme-linked immunoassays (EIA).
Furthermore isolation of HEV from peripheral blood lymphocytes and
from stools belonging to anti-HEV IgG-positive patients was attempted by
inoculation of HepG2 and Vero cell line cultures. The inoculated
cell cultures were examined after immunoperoxidase staining for the detection
of HEV antigen. Plasma, lymphocytes and stool samples from anti-HEV IgM
positive patients were examined for HEV RNA by PCR. Anti-HEV IgG was found in 144/435 (33%) of
these acute hepatitis patients. Anti-HEV (IgM) was detected in 8/52 (15.4%)
out of 52 chosen from the 144 sera that were anti-HEV IgG positive cases.
HEV was isolated in HepG2 from 32.6% of lymphocyte and from
34.9% of stools from patients positive for anti-HEV (IgG). While it was
isolated from 71.4% of lymphocytes and from 100% of stools from patients
positive for anti-HEV (IgM). In Vero cell cultures there was no HEV isolation from stools but HEV was
isolated from 50% of lymphocytes. HEV RNA was detected by PCR in 85.7% of
stools, 62.5% of plasma, and in 37.5% of lymphocyte samples belonging to
anti-HEV IgM positive cases. Analysis of these diagnostic tests indicated
that virus isolation from peripheral blood lymphocytes and stools by
inoculation of HepG2 cell cultures is more sensitive than
virus-RNA detection by PCR |
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