Seroepidemiological survey of hepatitis E in Hong Kong by recombinant-based enzyme immunoassays

Lancet. 1992 Nov 14;340(8829):1205-8. doi: 10.1016/0140-6736(92)92901-q.


The agent that causes the enterally transmitted form of non-A, non-B hepatitis has been cloned and called hepatitis E virus (HEV). We have carried out a seroepidemiological survey on the prevalence of hepatitis E in Hong Kong. In a retrospective study, serum from 394 patients with acute viral hepatitis and 355 healthy subjects was tested for antibodies to HEV (anti-HEV) with a recombinant-based enzyme immunoassay. 65 (16.5%) patients with hepatitis were positive for IgM anti-HEV and 23 (5.8%) were also positive for IgM anti-HEV. Of 18 patients diagnosed as having acute non-A, non-B, non-C hepatitis, 6 were IgM anti-HEV positive. 17 (6%) patients in whom acute hepatitis A was diagnosed were also infected with HEV. None of 70 patients with acute hepatitis B or C or exacerbation of chronic hepatitis B was IgM anti-HEV positive. 57 (16.1%) of the healthy subjects were positive for IgG anti-HEV. The prevalence of IgG anti-HEV was higher in subjects over 20 years old than in younger subjects (24% vs 4%, p < 0.0001). IgG anti-HEV was detected in 26% of subjects who were positive for IgG antibody to HAV and in 7% of those negative for that antibody (p < 0.0001). We demonstrated the validity of the recombinant-based enzyme immunoassays for the diagnosis of hepatitis E. Our results suggest that hepatitis E accounts for a third of non-A, non-B, non-C hepatitis in Hong Kong and that coinfection of hepatitis A and E can occur.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Female
  • Hepatitis Antibodies / blood*
  • Hepatitis E / diagnosis
  • Hepatitis E / epidemiology*
  • Hepatitis E / immunology
  • Hong Kong / epidemiology
  • Humans
  • Immunoenzyme Techniques
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prevalence
  • Recombinant Proteins
  • Retrospective Studies
  • Seroepidemiologic Studies
  • Serologic Tests / methods


  • Hepatitis Antibodies
  • Recombinant Proteins