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Test ID: HEVM Hepatitis E Virus IgM Antibody Screen with Reflex to Confirmation, Serum

Reporting Name

HEV IgM Ab Screen, S

Useful For

Diagnosis of acute or recent (<6 months) hepatitis E infection

Clinical Information

Hepatitis E virus (HEV) causes an acute, usually self-limited infection. This small, nonenveloped RNA virus is transmitted from animal reservoir (eg, hogs) to humans via the fecal-oral route. HEV is endemic in Southeast and Central Asia, with several outbreaks observed in the Middle East, northern and western parts of Africa, and Mexico. In developed countries, HEV infection occurs mainly in persons who have traveled to disease-endemic areas. Transmission of HEV may also occur parenterally, and direct person-to-person transmission is rare. Clinically severe cases occur in young to middle-aged adults. Unusually high mortality (approximately 20%) occurs in patients infected during the third trimester of pregnancy. Although there is no carrier state associated with HEV, immunocompromised patients may have prolonged periods (eg, months) of viremia and virus shedding in the feces.

 

In immunocompetent patients, viremia and virus shedding in the feces occur in the pre-icteric phase, lasting up to 10 days into the clinical phase. After an incubation period ranging from 15 to 60 days, HEV-infected patients develop symptoms of hepatitis with appearance of anti-HEV IgM antibody in serum, followed by detectable anti-HEV IgG within a few days. Anti-HEV IgM may remain detectable up to 6 months after onset of symptoms, while anti-HEV IgG usually persists for many years after infection. Anti-HEV IgM is the serologic marker of choice for diagnosis of acute HEV infection.

Interpretation

Positive results suggest the presence of acute or recent (in the preceding 6 months) hepatitis E infection.

 

Negative results indicate absence of acute or recent hepatitis E infection. If clinical suspicion persists, submit new specimen for retesting in 1 to 2 weeks.

 

Borderline results may be seen in acute hepatitis E infection with rising level of anti-hepatitis E virus (HEV) IgM,  recent hepatitis E infection with declining level of anti-HEV IgM, or cross-reactivity with nonspecific antibodies (ie, false-positive results).

Report Available

1 to 7 days

Day(s) Performed

Tuesday, Thursday

Clinical Reference

1. Aggarwal R, Jameel S: Hepatitis E. Hepatology. 2011 Dec;54(6):2218-2226

2. Hoofnagle JH, Nelson KE, Purcell RH: Hepatitis E. New Engl J Med. 2012 Sep;367(13):1237-1244

3. Aggarwal R: Diagnosis of hepatitis E. Nat Rev Gastroenterol Hepatol. 2013 Jan;10(1):24-33

Method Name

Enzyme Immunoassay (EIA)

Specimen Type

Serum SST


Necessary Information


Date of collection is required.



Specimen Required


Collection Container/Tube: Serum gel

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL

Collection Instructions:

1. Centrifuge blood collection tube per collection tube manufacturer's instructions (eg, centrifuge within 2 hours of collection for BD Vacutainer tubes).

2. Aliquot serum into plastic vial.


Specimen Minimum Volume

See Specimen Required

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum SST Frozen (preferred)
  Refrigerated  24 hours

Reference Values

Negative

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

86790

LOINC Code Information

Test ID Test Order Name Order LOINC Value
HEVM HEV IgM Ab Screen, S 14212-5

 

Result ID Test Result Name Result LOINC Value
86212 HEV IgM Ab Screen, S 14212-5

Testing Algorithm

If hepatitis E virus (HEV) IgM antibody screen is reactive or borderline, HEV IgM antibody confirmation will be performed at an additional charge.

 

For more information see Hepatitis E: Testing Algorithm for Diagnosis and Management.

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
HEVML HEV IgM Ab Confirmation, S Yes No

Forms

If not ordering electronically, complete, print, and send 1 of the following:

-Gastroenterology and Hepatology Test Request (T728)

-Infectious Disease Serology Test Request (T916)

-Microbiology Test Request (T244)

Mayo Clinic Laboratories | Microbiology and Infectious Disease Catalog Additional Information:

mml-hepatitis