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Performance Evaluation of Different Commercial Serological Kits for Diagnosis of Acute Hepatitis E Viral Infection


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Fig. 1.

Flow diagram for patients with acute viral hepatitis E.
Flow diagram for patients with acute viral hepatitis E.

Consistency for HEV Ag and HEV RNA assays in the diagnosis of the acute HEV infections.

HEV RNA +, n (%) HEV RNA −, n (%) Total, n (%)
HEV Ag +, n (%) 36 (41.86) 0 (0)   36 (41.86)
HEV Ag −, n (%) 8 (9.3) 42 (48.84)   50 (58.14)
Total, n (%) 44 (51.16) 42 (48.84) 86 (100)

Diagnostic performance of anti-HEV IgM assays.

Commercial tests % Sensitivity (95% CI) % Specificity (95% CI) % PPV (95% CI) % NPV (95% CI) AUC (95% CI) p % Specificity with RD (95% CI) % Specificity with CMV/EBV (95% CI) % Specificity with healthy (95% CI)
Wantai 84.9 (75.5–91.7) 100 (98.7–100) 100 (100–100) 95.5 (92.8–97.2) 0.924 (0.892–0.949) < 0.01 100 (100–100) 100 (100–100) 100 (100–100)
Kehua 86.0 (76.9–92.6) 100 (98.7–100) 100 (100–100) 95.9 (93.2–97.5) 0.930 (0.899–0.954) < 0.01 100 (100–100) 100 (100–100) 100 (100–100)
Lizhu 83.7 (74.2–90.8) 100 (98.7–100) 100 (100–100) 95.2 (92.5–97.0) 0.919 (0.886–0.945) < 0.01 100 (100–100) 100 (100–100) 100 (100–100)
Genelabs 82.6 (72.9–89.9) 99.3 (97.4–99.9) 97.3 (89.9–99.3) 94.8 (92.1–96.7) 0.909 (0.875–0.937) < 0.01 97.8 (94.8–100) 100 (100–100) 100 (100–100)

Concordance for anti-HEV IgM assays in the diagnosis of the acute HEV infections.

Commercial tests % Concordance Kappa (95% CI)
Wantai
Kehua 98.8 0.950 (0.852–1.000)
Lizhu 98.8 0.953 (0.862–1.000)
Genelabs 95.3 0.819 (0.648–0.990)
Kehua
Lizhu 97.7 0.903 (0.771–1.000)
Genelabs 96.5 0.860 (0.706–1.000)
Lizhu
Genelabs 96.5 0.868 (0.722–1.000)

Diagnostic performance of anti-HEV IgG assays.

Commercial tests % Sensitivity (95% CI) % Specificity (95% CI) % PPV (95% CI) % NPV (95% CI) AUC (95% CI) p % Specificity with RD (95% CI) % Specificity with CMV/EBV (95% CI) % Specificity with healthy (95% CI)
Wantai 91.9 (83.9–96.7) 74.8 (69.3–79.8) 53.0 (47.7–58.3) 96.7 (93.6–98.4) 0.833 (0.791–0.870) < 0.01 79.2 (71.0–87.3) 81.3 (73.3–89.3) 64.6 (55.0–74.1)
Kehua 87.2 (78.3–93.4) 97.5 (94.9–99.0) 91.5 (83.7–95.7) 96.1 (93.4–97.7) 0.923 (0.891–0.949) < 0.01 98.9 (96.6–100) 97.8 (94.8–100) 96.9 (93.4–100)
Lizhu 89.5 (81.1–95.1) 75.9 (70.4–80.8) 53.5 (48.0–58.9) 95.9 (92.6–97.8) 0.827 (0.784–0.865) < 0.01 83.5 (75.9–91.1) 74.7 (65.8–83.6) 69.8 (60.6–79.0)
Genelabs 88.4 (79.7–94.3) 97.5 (94.9–99.0) 91.6 (83.9–95.8) 96.4 (93.8–98.0) 0.929 (0.898–0.953) < 0.01 98.9 (96.6–100) 96.7 (93.0–100) 97.9 (95.0–100)

Concordance for anti-HEV IgG assays.

Commercial tests Concordance of HEV Concordance of RD Concordance of CMV/EBV Concordance of healthy
% Kappa (95% CI) % Kappa (95% CI) % Kappa (95% CI) % Kappa (95% CI)
Wantai
Kehua 95.3 0.753 (0.524–0.982) 80.2 0.081 (–0.069–0.231) 81.3 0.069 (–0.102–0.239) 68.8 0.147 (0.015–0.279)
Lizhu 98.8 0.927 (0.785–1.000) 91.2 0.712 (0.525–0.898) 88.5 0.809 (0.664–0.954) 94.8 0.882 (0.782–0.982)
Genelabs 96.5 0.805 (0.592–1.000) 80.2 0.081 (–0.069–0.231) 82.4 0.153 (–0.064–0.369) 67.7 0.111 (–0.007–0.229)
Kehua
Lizhu 96.5 0.823 (0.629–1.000) 84.6 0.107 (–0.087–0.300) 76.9 0.125 (–0.034–0.283) 74.0 0.183 (0.238–0.341)
Genelabs 96.5 0.837 (0.658–1.000) 100 1.000 (1.000–1.000) 98.9 0.795 (0.403–1.000) 99.0 0.852 (0.566–1.000)
Lizhu
Genelabs 95.3 0.752 (0.520–0.984) 84.6 0.107 (–0.087–0.300) 78.0 0.183 (0.001–0.366) 72.9 0.139 (–0.005–0.282)
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Biologie, Mikrobiologie und Virologie