Subclinical hepatitis E virus (HEV) infection detected by nucleic acid amplification test on blood donation: short-term positivity for immunoglobulin G class of antibody against HEV

• Published in: Clinical journal of gastroenterology 2022-08, Vol.15 (4), p.750-754
• Main Authors: Hasegawa, Izumi, Nakano, Tatsunori, Koguchi, Hiroki, Jinno, Naruomi, Hirashima, Noboru, Nagashima, Shigeo, Takahashi, Masaharu, Murata, Kazumoto, Okamoto, Hiroaki
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Case Report; Colorectal Surgery; Gastroenterology; Hepatology; Medicine; Medicine & Public Health; Surgical Oncology
• ISSN: 1865-7257; 1865-7265
• DOI: 10.1007/s12328-022-01635-3

A case of subclinical hepatitis E virus (HEV) infection was detected by nucleic acid amplification test on blood donation. The patient was followed-up until day 220 after the blood donation but showed no symptoms throughout the observation period. Aspartate aminotransferase and alanine aminotransferase levels reached the maximum values on day 37 with a slight increase but remained in normal ranges from day 67 to 220. The quantity of HEV RNA at the initial examination on day 13 was 1.1 × 10 2 copies/mL, which increased to 2.8 × 10 3 copies/mL by day 37. It was not detected from day 67 to 220. Immunoglobulin G class antibody to HEV (anti-HEV IgG) was below the cut-off value until day 37 and exceeded the cut-off value to positive on day 67, accompanied by normalization of liver function and negative conversion of HEV RNA. Thereafter, the titer decreased gradually, falling below the cut-off value on day 163, and continuing negative until day 220. Although the persistent duration of anti-HEV IgG positive is believed to be generally long, it was within only 126 days for this subclinical case. Further investigation is needed to determine whether short-term positivity for anti-HEV IgG is typical in subclinical HEV infection.