ASSESSING THE ROLE OF RT-PCR (REAL-TIME POLYMERASE CHAIN REACTION) IN DIAGNOSIS OF HEPATITIS E IN INDIAN SUBJECTS

Abstract

Background: Hepatitis E is a common subvariant seen in subjects affected with hepatitis. However, existing literature data depict a gap in knowledge about appropriate diagnostic tools and the true prevalence of acute hepatitis E infection.
Aim: The present study aimed to assess the prevalence of hepatitis E infection in acute hepatitis subjects in an Indian scenario and to assess the efficacy of prominent diagnostic assays in reaching the diagnosis.
Methods: The study assessed 92 subjects diagnosed with jaundice for <4 weeks with elevated levels of ALT and AST more than 500 U/L. The prevalence of hepatitis E infection in subjects with acute hepatitis was assessed based on several study participants showing a positive reaction in RT-PCR assay and serum anti-hepatitis E virus immunoglobulin M (IgM).
Results: Among 92 study subjects, 32.6% (n=30) and 23.9% (n=22) subjects were positive for RT-PCR and HEV-IgM respectively. Inter-test agreement was poor between the two tests depicting the necessity to perform both tests for accurate diagnosis. A significant difference was seen in RT-PCR negative and positive subjects to illness duration with p=0.007. The mean illness duration was 11.68±5.17 and 8.8±3.52 days respectively in the two groups. The evidence of acute HEV virus infection was 50% with combined RT-PCR and ELISA results.
Conclusions: The present study concludes that HEV is the most common cause of acute hepatitis in adult Indian subjects in the tertiary care center and its diagnosis should be made with the combined use of RT-PCR and ELISA tests.