Low Serological Agreement of Hepatitis E in Immunocompromised Cancer Patients: A Comparative Study of Three Anti-HEV Assays.

IF 3 Q3 IMMUNOLOGY
Antibodies Pub Date : 2025-03-24 DOI:10.3390/antib14020027
Isabel-Elena Haller, Mark Reinwald, Janine Kah, Franz A M Eggert, Sandra Schwarzlose-Schwarck, Kristoph Jahnke, Stefan Lüth, Werner Dammermann
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引用次数: 0

Abstract

Background/objectives: Hepatitis E virus (HEV) is one of the leading causes of acute hepatitis, with immunosuppressed individuals, such as oncology patients, being particularly vulnerable to chronic infections that may progress to liver disease or fatal outcomes. Assay variability complicates HEV prevalence assessment in at-risk groups. This study aimed to compare the reliability and concordance of three HEV antibody assays-Wantai, Euroimmun, and Elecsys®-in immunosuppressed oncology patients.

Methods: In this prospective pilot study, serum samples were obtained from oncology patients between September 2020 and October 2021. Samples were collected both at baseline (treatment-naive) and during ongoing treatment. A healthy control group was retrospectively included for comparative analysis. Anti-HEV IgM and IgG antibodies were tested in all samples using enzyme-linked immunosorbent assays (Wantai, Euroimmun) and an electrochemiluminescence immunoassay (Elecsys®). Demographic and clinical data, along with information on HEV risk factors, were extracted from medical records and patient questionnaires.

Results: HEV IgM prevalence ranged from 0% (Wantai) to 6% (Elecsys®), while IgG prevalence was 12% (Euroimmun), 38% (Wantai), and 53% (Elecsys®). Concordance was poor, with Cohen's Kappa values indicating slight to moderate agreement (κ = 0.000-0.553). Patients with hematological malignancies exhibited the highest IgG seroprevalence. Risk factor analysis revealed the highest association between HEV exposure and the consumption of undercooked pork or crop-based agriculture.

Conclusions: Significant variability among HEV serological assays highlights the challenges of reliable HEV diagnostics in immunosuppressed oncology patients. Assay selection and improved testing strategies are critical for this high-risk group.

免疫功能低下的癌症患者戊型肝炎的低血清学一致性:三种抗戊型肝炎检测的比较研究
背景/目的:戊型肝炎病毒(HEV)是急性肝炎的主要原因之一,免疫抑制的个体,如肿瘤患者,特别容易受到慢性感染,可能发展为肝脏疾病或致命的结果。检测差异使高危人群的HEV流行评估复杂化。本研究旨在比较三种HEV抗体检测方法(wantai、euroimmune和Elecsys®)在免疫抑制肿瘤患者中的可靠性和一致性。方法:在这项前瞻性先导研究中,从2020年9月至2021年10月期间的肿瘤患者中获得血清样本。在基线(治疗初期)和持续治疗期间收集样本。回顾性纳入健康对照组进行比较分析。使用酶联免疫吸附法(Wantai, euroimmune)和电化学发光免疫分析法(Elecsys®)检测所有样品中的抗hev IgM和IgG抗体。从医疗记录和患者问卷中提取了人口统计学和临床数据以及HEV风险因素信息。结果:HEV IgM患病率从0%(万泰)到6% (Elecsys®)不等,IgG患病率为12% (euroimmune), 38%(万泰)和53% (Elecsys®)。一致性较差,Cohen’s Kappa值表明一致性轻微至中度(κ = 0.000-0.553)。血液学恶性肿瘤患者IgG血清阳性率最高。风险因素分析显示,HEV暴露与食用未煮熟的猪肉或以作物为基础的农业之间的相关性最高。结论:HEV血清学检测的显著差异凸显了在免疫抑制肿瘤患者中进行可靠的HEV诊断的挑战。检测选择和改进的检测策略对这一高危人群至关重要。
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来源期刊
Antibodies
Antibodies IMMUNOLOGY-
CiteScore
7.10
自引率
6.40%
发文量
68
审稿时长
11 weeks
期刊介绍: Antibodies (ISSN 2073-4468), an international, peer-reviewed open access journal which provides an advanced forum for studies related to antibodies and antigens. It publishes reviews, research articles, communications and short notes. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. Full experimental and/or methodical details must be provided. Electronic files or software regarding the full details of the calculation and experimental procedure - if unable to be published in a normal way - can be deposited as supplementary material. This journal covers all topics related to antibodies and antigens, topics of interest include (but are not limited to): antibody-producing cells (including B cells), antibody structure and function, antibody-antigen interactions, Fc receptors, antibody manufacturing antibody engineering, antibody therapy, immunoassays, antibody diagnosis, tissue antigens, exogenous antigens, endogenous antigens, autoantigens, monoclonal antibodies, natural antibodies, humoral immune responses, immunoregulatory molecules.
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