Andriesse Gunnar I, Donmez Mustafa, Vissers Jamie, van Wijngaarden Peter
Amphia Ziekenhuis, Breda, Afd. Medische Microbiologie, the Netherlands.
Ned Tijdschr Geneeskd. 2010;154:A1865.
To determine the percentage of hepatitis E virus (HEV) infections in serum samples from patients with negative serology for hepatitis A, B and C and to find out what may be the harmful consequences of a missed diagnosis of acute HEV infection.
Retrospective study.
Serum samples were selected from patients with infectious hepatitis who tested negative for hepatitis A, B and C virus. Serum samples that had elevated alanine aminotransferase (ALT; > 34 U/l) were included in this study. All samples were then tested for HEV using an enzyme-linked immunosorbent assay (ELISA) and immunoblot assay. Of patients with serological evidence of acute HEV, files were checked for the originally documented diagnosis at hospital discharge.
In the period October 2007-September 2008, 139 serum samples met the inclusion criteria. In 23 serum samples the ELISA was positive (IgM positive and/or Ig total positive); in 16/23 serum samples immunoblot assay was also positive. The percentage of confirmed HEV infections was 11.5% (16/139). In only one patient was the originally documented diagnosis correct. Several patients underwent invasive diagnostic procedures and treatment as a result of an incorrect diagnosis.
Hepatitis E serology should be a standard tool in the diagnostic workup of infectious hepatitis patients in the Netherlands.
确定甲、乙、丙型肝炎血清学检测呈阴性的患者血清样本中戊型肝炎病毒（HEV）感染的百分比，并找出急性戊型肝炎感染漏诊可能产生的有害后果。
回顾性研究。
从甲型、乙型和丙型肝炎病毒检测呈阴性的传染性肝炎患者中选取血清样本。本研究纳入丙氨酸转氨酶（ALT；> 34 U/l）升高的血清样本。然后使用酶联免疫吸附测定（ELISA）和免疫印迹测定对所有样本进行戊型肝炎病毒检测。对于有急性戊型肝炎血清学证据的患者，检查其出院时医院最初记录的诊断。
在2007年10月至2008年9月期间，139份血清样本符合纳入标准。23份血清样本的ELISA检测呈阳性（IgM阳性和/或总Ig阳性）；在16/23份血清样本中免疫印迹测定也呈阳性。确诊的戊型肝炎病毒感染百分比为11.5%（16/139）。只有一名患者最初记录的诊断是正确的。由于诊断错误，几名患者接受了侵入性诊断程序和治疗。
在荷兰，戊型肝炎血清学检测应成为传染性肝炎患者诊断检查的标准工具。
