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Hepatitis E PCR


Blood
Test performed by: LabPLUS VIM Molecular Diagnostics


Specimen Collection

A dedicated specimen (i.e. no other tests to be performed) is required for this assay.

Do not use heparin tubes

All micro collects MUST be EDTA.


PPT5 mL PPT Plasma (Preferred)

Do not freeze unseparated PPT tubes . If the specimen requires freezing, the supernatant must be removed from the gel first.

Require a dedicated PPT tube specimen (no other tests requested).

Centrifuge PPT tube within 24 hours of collection.
Transport at 2 - 8 degrees C if transport time from collection is less than 72 hours. Transport frozen if more than 72 hours.


EDTA4 mL EDTA Plasma
SST3.5 mL SST Serum
Assay Method

RTP CR

Real-time PCR assay targetting   the ORF3 region of HEV genome.



Faecal
Test performed by: LabPLUS VIM Molecular Diagnostics


Acute phase


Turnaround Time:

Tests performed as requested. Result available within 5 days.


 


Diagnostic Use and Interpretation

Hepatitis E virus is responsible for enterically-transmitted acute hepaititis in humans with two distinct epidemiological patterns. In endemic regions, large waterborne epidemics have been observed with thousands of people affected. In non-epidemic regions, sporadic cases may occur.

4 genotypes of HEV are described. Genotypes 1 and 2 are strictly human infections, genotypes 3 and 4 are found both in humans and other mammals. Infection in domestic and wild pigs is common and pig herds in NZ have a high prevalence of infection. Sporadic cases of HEV have been linked to eating meat from infected animals although in general the source of infection is uncertain.

Infection with genotype 1 or 2 usually causes a self-limiting hepatitis with low mortality except in pregnant women, in whom the mortality may reach 25%   especially in the 3 rd trimester. Genotypes 3 and 4 infections are zoonotic with an apparent predilection for elderly men. Symptoms range from inapparent to acute or sub-acute liver failure, with associated neurological symptoms in a minority of patients. Despite earlier belief that HEV was always self-limiting, infection can become chronic in immunosuppressed patients.

 

  References:

1. Garkavenko O, Obriadina D, Meng J,. et al. Detection and characterisation of Swine hepatitis E virus in New Zealand, J . Med. Virol. 65(2001), pp525-529.

2. Pavio n, Meng X-J, Renou C. Zoonotic hepatitis E: animal reservoirs and emerging risks. Vet Res (2010)41:46.

3. Matsuda H., Okada K., Takahashi K. and Mishiro S. Severe hepatitis E virus infection after ingestion of uncooked liver from a wild boar, J. Infect. Dis. 188 (2003) (6), p. 944.

4. Scobie L, Dalton HR. Hepatitis E: source and route of infection, clinical manifestations and new developments. (2013) J Viral Hepatitis. 20:1-11.

5. Narayanan Jothikumar, Theresa L. Cromeans, Betty H. Robertson, X.J. Meng and Vincent R. Hill. A broadly reactive one-step real-time RT-PCR assay for rapid and sensitive detection of hepatitis E virus ; Journal of Virological Methods. 131(2006) 1, Pages 65-71. .


Contact Information

For further information contact the laboratory  (contact via Lablink: 22000 or (09) 307-8995 or 0800 522 7587) ,or:
the Virology team virology@adhb.govt.nz

 



Last updated at 14:23:35 08/07/2020