{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T16:53:12Z","timestamp":1717606392500},"reference-count":18,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2002,9,1]],"date-time":"2002-09-01T00:00:00Z","timestamp":1030838400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Clin Vaccine Immunol"],"published-print":{"date-parts":[[2002,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>Diagnosis of acute hepatitis E by detection of hepatitis E virus (HEV)-specific immunoglobulin M (IgM) is an established procedure. We investigated whether quantitation of HEV IgM and its ratio to HEV total Ig furnished more information than conventional IgM tests that are interpreted as positive or negative. A previously described indirect immunoassay for total Ig against a baculovirus-expressed HEV capsid protein was modified to quantitate HEV-specific IgM in Walter Reed (WR) antibody units by using a reference antiserum and the four-parameter logistic model. A receiver-operating characteristics curve derived from 197 true-positive specimens and 449 true-negative specimens identified 30 WR units\/ml as an optimum cut point. The median HEV IgM level in 36 patients with acute hepatitis E fell from 3,000 to 100 WR units\/ml over 6 months, suggesting that 100 WR units\/ml would be a more appropriate cut point for distinguishing recent from remote IgM responses. Among three hepatitis E case series, determination of the HEV IgM-to-total-Ig ratio in acute-phase serum revealed that most patients had high ratios consistent with primary infections whereas a few had low ratios, suggesting that they had sustained reinfections that elicited anamnestic antibody responses. The diagnostic utility of the new IgM test was similar to that of a commercially available test that uses different HEV antigens. In conclusion, we found that HEV IgM can be detected specifically in &gt;95% of acute hepatitis E cases defined by detection of the virus genome in serum and that quantitation of HEV IgM and its ratio to total Ig provides insight into infection timing and prior immunity.<\/jats:p>","DOI":"10.1128\/cdli.9.5.1072-1078.2002","type":"journal-article","created":{"date-parts":[[2002,8,30]],"date-time":"2002-08-30T18:44:29Z","timestamp":1030733069000},"page":"1072-1078","update-policy":"http:\/\/dx.doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":5,"title":["Clinical and Epidemiological Relevance of Quantitating Hepatitis E Virus-Specific Immunoglobulin M"],"prefix":"10.1128","volume":"9","author":[{"given":"Jitvimol","family":"Seriwatana","sequence":"first","affiliation":[{"name":"Department of Virus Diseases, Walter Reed Army Institute of Research, Silver Spring, Maryland 20910"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mrigendra P.","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Walter Reed\/Armed Forces Research Institute of Medical Sciences Research Unit\u2014Nepal, Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert M.","family":"Scott","sequence":"additional","affiliation":[{"name":"Walter Reed\/Armed Forces Research Institute of Medical Sciences Research Unit\u2014Nepal, Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergei A.","family":"Tsarev","sequence":"additional","affiliation":[{"name":"Department of Virus Diseases, Walter Reed Army Institute of Research, Silver Spring, Maryland 20910"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David W.","family":"Vaughn","sequence":"additional","affiliation":[{"name":"Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khin Saw Aye","family":"Myint","sequence":"additional","affiliation":[{"name":"Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce L.","family":"Innis","sequence":"additional","affiliation":[{"name":"Department of Virus Diseases, Walter Reed Army Institute of Research, Silver Spring, Maryland 20910"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1111\/j.1365-2893.1997.tb00215.x","volume":"4","year":"1997","unstructured":"Chobe, L. 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