Hepatitis E

Test code: S0123 - Ultrasensitive qualitative detection of hepatitis E virus by reverse transcription coupled real time polymerase chain reaction

Hepatitis E virus (HEV) is transmitted by the fecal-oral route and the disease is usually self-limiting. It is often spread by fecally contaminated water within endemic areas. It has many similarities with hepatitis A.

Because of similar physicochemical and biological properties, HEV is classified in the Caliciviridae family. However, recent molecular study has shown that the HEV genome is different from the other caliciviruses, and suggests that its genomic sequences are more similar to those of rubella virus. Therefore, HEV eventually may be reclassified.

Domestic animals have been reported as a reservoir for the hepatitis E virus, with some surveys showing infection rates exceeding 95% among domestic pigs (Satou and Nishiura, 2007). Consumption of wild boar meat and uncooked deer meat has been reported to transmit the virus. Rats also carry the virus.

Zoonotic transmission of this virus from pet pigs to owners is a growing concern. Pigs also may be a source of HEV infection of humans through xenotransplantation of pig tissues or organs, such as liver, pancreas, and heart, to humans.

Detection of HEV infection by bioassay or serological methods is labor intensive and has low sensitivity. Molecular detection by PCR is a rapid, specific and sensitive alternative (Lin et al. 2000).

Utilities:

• Confirm the disease causing agent
• Identify HEV carriers
• Ensure that animal groups and populations are free of HEV
• Early prevention of spread of the virus among animals
• Minimize human exposure to the virus
• Safety monitoring of biological products that derive from animals

References:
Lin, C.C., Wu, J.C., Chang, T.T., Chang, W.Y., Yu, M.L., Tam, A.W., Wang, S.C., Huang, Y.H., Chang, F.Y., and Lee, S.D. (2000) Diagnostic value of immunoglobulin G (IgG) and IgM anti-hepatitis E virus (HEV) tests based on HEV RNA in an area where hepatitis E is not endemic. J. Clin. Microbiol. 38:3915-3918.

Satou, K. and Nishiura, H (2007) Transmission dynamics of hepatitis E among swine: potential impact upon human infection. BMC Vet. Res. 3:9

Specimen requirements: 0.5 ml whole blood in EDTA (purple top) or ACD (yellow top) tube, or 0.5 ml feces, or rectal swab, or tissue, shipped overnight at room temperature.

For specimen types other than those listed here, please call to confirm specimen acceptability and shipping instructions.

For all specimen types, if there will be a delay in shipping, or during very warm weather, refrigerate specimens until shipped and ship with a cold pack unless more stringent shipping requirements are specified. Frozen specimens should be shipped so as to remain frozen in transit. See shipping instructions for more information.

Turnaround time: 2 business days

Methodology: Qualitative reverse transcription coupled real time PCR

Normal range: Nondetected