Two generations of "gold standards": The impact of a decade in hepatitis e virus testing innovation on population seroprevalence

Brittany L. Kmush, Alain B. Labrique, Harry R. Dalton, Zabed B. Ahmed, John R. Ticehurst, Christopher D. Heaney, Kenrad E. Nelson, Khalequ Zaman

Research output: Contribution to journalArticle

18 Scopus citations


Hepatitis E virus (HEV) is a global pathogen responsible for approximately 20 million infections every year in developing countries, yet remains under-recognized. In this population-based cohort study, 1,025 randomly selected participants were enrolled from Matlab, Bangladesh (2004-2005). All participants were tested for HEV antibodies and total immunoglobulin (Ig), using an in-house enzyme immunoassay developed by Walter Reed Army Institute of Research (WRAIR). In 2014, we retested the banked sera of 1,009 of those participants using the Wantai anti-HEV IgG enzymelinked immunosorbent assay (ELISA). The WRAIR assay estimated the overall population seroprevalence as 26.6% (95% confidence interval [CI]: 24.0, 29.5), whereas the Wantai assay produced significantly higher estimated seroprevalence, 46.7% (95% CI: 43.5-49.8) (P <0.001). However, the two tests give nearly identical findings in those 5 years and under (N = 94) with a 98% agreement between the tests. Retesting populations with modern assays is necessary to establish better population-level estimates of disease burden.

Original languageEnglish (US)
Pages (from-to)714-717
Number of pages4
JournalAmerican Journal of Tropical Medicine and Hygiene
Issue number4
StatePublished - Oct 1 2015


ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases
  • Virology

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