The University of Groningen, University Medical Center Groningen, Department of Medical Microbiology, Groningen, The Netherlands.
Izore Centre for Infectious Diseases Friesland, Medical Microbiology, Leeuwarden, The Netherlands.
Clin Microbiol Infect. 2017 Sep;23(9):667-671. doi: 10.1016/j.cmi.2017.02.026. Epub 2017 Mar 7.
Hepatitis E virus (HEV) genotype 3 is endemic in Europe and an underdiagnosed and emerging (public) health issue. In recent years commercial enzyme immunoassays (EIAs) that detect antibodies to HEV more adequately, became available. We investigated the added value of this HEV serology in the diagnostic work flow to detect viral causes of recent hepatitis.
During a 2-year period (May 2013 to May 2015), HEV serology was added to the hepatitis work flow, consisting of serological detection of hepatitis viruses A, B and C (HAV, HBV, HCV), Epstein-Barr virus (EBV) and cytomegalovirus (CMV). Samples positive for HEV IgM were also analysed using PCR to detect HEV RNA. If positive, HEV sequencing was performed for genotyping purposes.
In 235 out of 2521 patients (9.3%), a viral cause for hepatitis was found. Recent HAV, HBV, HCV, EBV or CMV infections were serologically diagnosed in 3, 34, 10, 69 and 42 patients, respectively. Seventy-eight patients (3.1%) had a recent HEV infection. In 49 of them, sufficient HEV RNA was present for genotyping. All patients were infected with HEV genotype 3.
In our region, an HEV infection is the most frequently diagnosed viral cause for recent hepatitis. These results indicate that, in a country where HEV is endemic, serological HEV diagnostics should be added to the standard work-up for viral hepatitis.
戊型肝炎病毒（HEV）基因型 3 在欧洲流行，是一个诊断不足且正在出现的（公共）健康问题。近年来，能够更充分地检测抗 HEV 抗体的商业酶联免疫吸附试验（EIA）已经问世。我们研究了这种 HEV 血清学检测在诊断近期肝炎病毒病因方面的附加价值。
在 2 年期间（2013 年 5 月至 2015 年 5 月），将 HEV 血清学检测添加到包括甲型肝炎病毒（HAV）、乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）、EB 病毒（EBV）和巨细胞病毒（CMV）在内的肝炎检测工作流程中。HEV IgM 阳性的样本也用 PCR 进行分析，以检测 HEV RNA。如果阳性，则进行 HEV 测序以确定基因型。
在 2521 例患者中的 235 例（9.3%）中，发现了肝炎的病毒病因。近期 HAV、HBV、HCV、EBV 或 CMV 感染分别在 3、34、10、69 和 42 例患者中通过血清学诊断。78 例（3.1%）患者发生近期 HEV 感染。其中 49 例患者有足够的 HEV RNA 进行基因分型。所有患者均感染了 HEV 基因型 3。
在我们的地区，HEV 感染是近期肝炎最常见的病毒病因。这些结果表明，在 HEV 流行的国家，血清学 HEV 诊断应添加到病毒性肝炎的标准检测中。
