Anti Hepatitis E Virus (HEV) - IgG

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Anti-HEV IgG test detects Immunoglobulin G (IgG) antibodies produced by the immune system in response to Hepatitis E Virus infection

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Anti Hepatitis E Virus (HEV) - IgG Test Information Guide

Why is it done?
- Test Purpose: Detects IgG antibodies against Hepatitis E Virus, indicating past or resolved HEV infection and immunity to the virus
- Primary Indications: Assessment of immunity status after HEV infection; serological confirmation of previous hepatitis E exposure; epidemiological studies; blood/organ donor screening; evaluation of chronic liver disease patients
- Clinical Circumstances: Performed weeks to months after acute HEV infection symptoms; assessment of recovery phase; screening in endemic areas; evaluation of immunocompromised patients with liver disease; post-vaccination immunity confirmation
Normal Range
- Reference Values: Negative/Non-Reactive: <1.0 S/CO (Signal to Cutoff ratio) or <0.8 mIU/mL (depending on assay methodology); Positive/Reactive: ≥1.0 S/CO or ≥0.8 mIU/mL
- Units of Measurement: S/CO (Signal to Cutoff ratio), mIU/mL (milliunits per milliliter), or qualitative positive/negative designation
- Interpretation - Negative Result: No detectable anti-HEV IgG antibodies; indicates no previous HEV infection or exposure; person is susceptible to hepatitis E infection
- Interpretation - Positive Result: Detectable anti-HEV IgG antibodies present; indicates past or resolved HEV infection; person has developed immunity and typically cannot be reinfected
- Borderline Values: Results near the cutoff range (typically 0.8-1.2 S/CO) may require repeat testing or additional confirmation with HEV IgM or HEV RNA to clarify infection status
Interpretation
- Positive Anti-HEV IgG (with Negative IgM): Indicates past HEV infection that has resolved; person is immune to future infection; commonly seen in endemic regions where HEV exposure is prevalent
- Positive Anti-HEV IgG with Positive IgM: Suggests acute or recent HEV infection; patient is in recovery phase but still infectious; requires urgent clinical correlation and possible HEV RNA testing
- Negative Anti-HEV IgG: No evidence of HEV infection; person susceptible to infection; if acute hepatitis suspected, repeat testing may be needed as IgG takes 2-4 weeks to develop
- Factors Affecting Results: Timing of infection; immunocompromised status (may show delayed or absent response); assay sensitivity and specificity; recent HEV vaccination; geographic variation in HEV genotypes; presence of rheumatoid factor or other immunoglobulins affecting test accuracy
- Clinical Significance: Positive results indicate durable immunity in immunocompetent individuals; used for epidemiological surveillance to estimate HEV exposure in populations; critical for screening blood and organ donors in endemic areas; helps differentiate past from acute infection when combined with clinical presentation and other serological markers
Associated Organs
- Primary Organ System: Hepatic system (liver); primarily affects hepatocytes where viral replication occurs
- Associated Conditions with Positive Results: Past hepatitis E infection; chronic hepatitis E (in immunocompromised patients); cirrhosis development risk; fulminant hepatic failure in pregnancy or pre-existing liver disease
- Diseases Diagnosed or Monitored: Hepatitis E infection; chronic hepatitis E (immunocompromised hosts); co-infection with hepatitis A, B, or C; autoimmune hepatitis; non-alcoholic fatty liver disease progression
- Potential Complications: Acute liver failure (rare in general population, common in pregnant women); chronic hepatitis E in transplant recipients; cirrhosis; hepatic encephalopathy; coagulopathy; thrombocytopenia; neurological manifestations (peripheral neuropathy, Guillain-Barré syndrome)
- Secondary Organs Affected: Kidneys (acute kidney injury in severe cases); pancreas (pancreatitis); nervous system (neurological complications); blood and spleen (hemolytic anemia, thrombocytopenia)
Follow-up Tests
- Recommended Follow-up Tests if Positive: Anti-HEV IgM (to assess acute vs. past infection); HEV RNA by PCR (to determine active viral replication); Liver function tests (AST, ALT, bilirubin, alkaline phosphatase); Prothrombin time/INR; Complete blood count; Hepatitis A, B, and C serologies
- Recommended Follow-up Tests if Negative: Anti-HEV IgM testing (if acute infection suspected); HEV RNA testing (early acute infection may have detectable RNA before antibodies); repeat IgG testing at 4-6 weeks if initial test done during acute phase
- Monitoring for Chronic Infection: In immunocompromised patients: HEV RNA PCR every 3-6 months; Liver function tests quarterly; Imaging studies (ultrasound/transient elastography) annually for cirrhosis assessment
- Complementary Tests: Abdominal ultrasound (assess liver structure and cirrhosis); Transient elastography (measure liver fibrosis); Liver biopsy (if chronic infection suspected); Anti-HEV IgG avidity testing (to differentiate acute from past infection in some cases)
- Post-Vaccination Monitoring: Anti-HEV IgG testing 4-8 weeks after completing HEV vaccine series to confirm protective immunity; repeat testing annually or after booster doses as per vaccine protocols
Fasting Required?
- Fasting Requirement: No - Fasting is NOT required for this test
- Patient Preparation: Patient may eat and drink normally before blood collection; no special dietary modifications needed
- Medications: All medications may be taken as prescribed; no need to withhold medications; antiviral medications do not interfere with serological test accuracy
- Other Special Instructions: Simple blood draw procedure requiring minimal preparation; can be performed any time of day; patient should remain seated for 5 minutes after blood collection to prevent vasovagal reactions
- Sample Collection: Single venous blood draw (approximately 5-10 mL); collected in standard serum separator tube; samples stable for transport and storage according to laboratory protocols

How our test process works!