Two generations of "gold standards": The impact of a decade in hepatitis e virus testing innovation on population seroprevalence

Brittany L. Kmush, Alain B Labrique, Harry R. Dalton, Zabed B. Ahmed, John R Ticehurst, Christopher David Heaney, Kenrad Edwin Nelson, Khalequ Zaman

Research output: Contribution to journalArticle

Abstract

Hepatitis E virus (HEV) is a global pathogen responsible for approximately 20 million infections every year in developing countries, yet remains under-recognized. In this population-based cohort study, 1,025 randomly selected participants were enrolled from Matlab, Bangladesh (2004-2005). All participants were tested for HEV antibodies and total immunoglobulin (Ig), using an in-house enzyme immunoassay developed by Walter Reed Army Institute of Research (WRAIR). In 2014, we retested the banked sera of 1,009 of those participants using the Wantai anti-HEV IgG enzymelinked immunosorbent assay (ELISA). The WRAIR assay estimated the overall population seroprevalence as 26.6% (95% confidence interval [CI]: 24.0, 29.5), whereas the Wantai assay produced significantly higher estimated seroprevalence, 46.7% (95% CI: 43.5-49.8) (P <0.001). However, the two tests give nearly identical findings in those 5 years and under (N = 94) with a 98% agreement between the tests. Retesting populations with modern assays is necessary to establish better population-level estimates of disease burden.

Original languageEnglish (US)
Pages (from-to)714-717
Number of pages4
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume93
Issue number4
DOIs
StatePublished - Oct 1 2015

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Hepatitis Viruses
Seroepidemiologic Studies
Hepatitis E virus
Population
Confidence Intervals
Immunosorbents
Bangladesh
Immunoenzyme Techniques
Developing Countries
Immunoglobulins
Cohort Studies
Immunoglobulin G
Antibodies
Infection
Serum

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases
  • Virology

Cite this

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abstract = "Hepatitis E virus (HEV) is a global pathogen responsible for approximately 20 million infections every year in developing countries, yet remains under-recognized. In this population-based cohort study, 1,025 randomly selected participants were enrolled from Matlab, Bangladesh (2004-2005). All participants were tested for HEV antibodies and total immunoglobulin (Ig), using an in-house enzyme immunoassay developed by Walter Reed Army Institute of Research (WRAIR). In 2014, we retested the banked sera of 1,009 of those participants using the Wantai anti-HEV IgG enzymelinked immunosorbent assay (ELISA). The WRAIR assay estimated the overall population seroprevalence as 26.6{\%} (95{\%} confidence interval [CI]: 24.0, 29.5), whereas the Wantai assay produced significantly higher estimated seroprevalence, 46.7{\%} (95{\%} CI: 43.5-49.8) (P <0.001). However, the two tests give nearly identical findings in those 5 years and under (N = 94) with a 98{\%} agreement between the tests. Retesting populations with modern assays is necessary to establish better population-level estimates of disease burden.",
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AU - Heaney, Christopher David

AU - Nelson, Kenrad Edwin

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