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What is Hepatitis E Test?

Hepatitis E or HEV is an RNA virus that leads to acute inflammation in the liver and, in severe cases, results in acute liver failure. The disease spreads through unhygienic and uncooked food, contaminated water, unhygienic environment, and in some cases a blood transfusion.
There are four different genetically different types of HEVs however, only two of those cause infection in human beings.

Hepatitis E test detects HEV infection by assessing the presence of certain proteins (IgM and IgG antibodies) secreted by the immune system to fight against this infection.

  1. Why is Hepatitis E test performed?
  2. How do you prepare for Hepatitis E test?
  3. How is Hepatitis E test performed?
  4. What do Hepatitis E test results mean?

HEV is responsible for causing epidemics in unclean and unhealthy regions throughout the world and in India. According to research, 92% of hepatitis epidemics that are not caused by hepatitis A or B viruses are due to HEV. Another study shows that 70% of the cases of acute viral hepatitis in children in India are caused by HEV.

Recovery from the HEV infection occurs without any complications in a majority of people. However, in some cases, an acute attack of HEV leads to liver failure, which is common in pregnant women and people who were previously suffering from other liver diseases. In another research, it is shown that during an epidemic of the HEV infection, number (20%) of pregnant women suffer from an acute episode of HEV hepatitis compared with other people. HEV infection in a pregnant woman can result in low birth weight, premature delivery of the baby or stillbirth.

So, a hepatitis E test is advised when patients, pregnant women, travellers, children or people with a weak immune system show the following symptoms:

The above symptoms develop within 40 days after the virus enters the body.

No special preparations are needed for this test.

Make sure to inform your doctor if you have undergone any test or investigation involving radioactive substance, within 1 week before the hepatitis E test as it can provide wrong or false-positive results.

It is a simple test, in which, a lab technician will withdraw a sample of blood from your arm and collect in tubes with a red cover for further examination.

Hepatitis E test helps in the diagnosis of HEV infection in the body by detecting antibodies secreted against the HEV antigen.

Normal results:

Negative values for IgM and IgG anti-HEV antibodies indicate the absence of HEV infection.

Abnormal results:

Positive values may indicate the following:

  • Positive results for IgM antibodies indicate the presence of an infection in the body
  • IgM antibodies appear for 4 to 5 months after the HEV infection
  • Detection of IgM antibodies confirms the diagnosis of acute HEV infection in people with the weak immune system
  • Positive results for IgG antibodies signify acute or chronic infection in the body
  • A positive result for HEV RNA shows the presence of the genetic material of HEV in the stool sample. confirming the diagnosis of hepatitis E in the case of negative results for IgM antibodies in the blood

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.

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References

  1. Center for Disease Control and Prevention [internet], Atlanta (GA): US Department of Health and Human Services; Hepatitis E
  2. Satsangi S, Chawla YK. Viral hepatitis: Indian scenario. 2016 Jul;72(3):204-10. PMID: 27546957
  3. National Institute of Diabetes and Digestive and Kidney Diseases [internet]: US Department of Health and Human Services; Hepatitis E
  4. Stuart Ralston, Ian Penman, Mark Strachan, Richard Hobson. Davidson's Principles and Practice of Medicine. 23rd edition, ISBN: 9780702070273.
  5. Denise. D. Wilson. McGraw-Hill Manual of Laboratory and Diagnostic Tests. 1st Edition; ISBN10: 0071481524
  6. Abravanel F, Chapuy-Regaud S, Lhomme S, Miedougé M, Peron JM, Alric L, Rostaing L, Kamar N, Izopet J. Performance of anti-HEV assays for diagnosing acute hepatitis E in immunocompromised patients. J Clin Virol. 2013 Dec;58(4):624-8. PMID: 24183927
  7. Aggarwal R. Diagnosis of hepatitis E. Nat Rev Gastroenterol Hepatol. 2013 Jan;10(1):24-33. PMID: 23026902
  8. Perez-Gracia MT, García M, Suay B, Mateos-Lindemann ML. Current Knowledge on Hepatitis E. J Clin Transl Hepatol. 2015 Jun 28;3(2):117-26. PMID: 26355220