Transcript HAV+and+HEV Presentation

Hepatitis A and Hepatitis E
A life threatening need for differential diagnosis
Hepatitis A and Hepatitis E
Similarities

Acute viral hepatitis

Transmitted via
fecal-oral route
Jaundice in 50% cases
Clinical symptoms
Supportive therapeutics



But they are different diseases!
Different Viral Family
Hepatitis A Virus
Hepatitis E Virus
ssRNA picornavirus
Single serotype worldwide
Vaccine is available
ssRNA hepevirus
1 serotype, 4 genotypes
Vaccine is being developed
Different Transmission Routes
Hepatitis A
 Contaminated food, water
infected food handlers
 raw shellfish
Hepatitis E
 Contaminated
food and water

 Close personal contact
household contact
 homosexual in men
 child day care centers

 Rarely by blood exposure
intravenous drug use
 blood transfusion

 Rarely from person to
 Possible
person
zoonotic transmission
Different Incubation Times
Hepatitis A
Hepatitis E
 15-45 days, average 30 days
 15-60 days, average 50 days
Different Population
Hepatitis A

Affects all age groups,
Particularly common in
children & young adults
 The most common acute
viral hepatitis
Hepatitis E
 Symptomatic infection is common
in young adults between 15-40 yrs
Genotype 1: 15-35 yrs
 Genotype 3-4: Japanese >60 yrs
 Genotype 1-2: human
 Genotype 3-4: human & animal

 Asymptomatic or atypical
infection seen mostly in children
 Found primarily in Asian, Africa
and South America
Different Disease Course
Hepatitis A
 Mild illness
 Complications:
 Fulminant hepatitis
 Cholestatic hepatitis
 Relapsing hepatitis
 0.4% fatality rate
 Self limiting,
no reports of chronic status
Hepatitis E
 Mild illness in most cases
 Complications:
 Fulminant hepatitis
 Hepatic cirrhosis in these with immunocompromised conditions
 1-2% fatality rate, but could go
 up to 75% with chronic liver disease
 20% in the 3rd trimester pregnant
women
 up to 33% of premature infants
 Self limiting, chronic status in these with
immunocompromised conditions
HAV and HEV co-infection in young children may lead to LIVER FAILURE
Different IgM Generation Time
Hepatitis A
Appears in the 1st week
of infection
 Peaks at 4 weeks
 Detectable up to 2-3 months

Hepatitis E
Appears in the 2nd week
of infection
 Peaks at 7 weeks
 Detectable up to 4 months

IgM detection is the most common specific diagnostics
Current Clinical Status of HAV and HEV

HEV is often under diagnosed or misdiagnosed:



HAV is the most common acute viral hepatitis
Lack of awareness of the differences between HEV and HAV
Lack of awareness = Diagnostic kits are unavailable, in particular,
HEV test kits are not well-known on the market

HEV is more severe than HAV in high risk groups &
requires prompt action to prevent disease progression

HAV and HEV co-infection in young children may lead
to liver failure!
Differential diagnosis of HEV and HAV will save lives
CTK Biotech Offers
Easy to use screening kits
OnSite HAV IgM Rapid Test kit
 OnSite HEV IgM Rapid Test kit

Complimenting confirmation kits
HAV IgM ELISA kit
 RecimbilisA HEV IgM ELISA kit

To aid in differential diagnosis of HEV and HAV
OnSite HAV IgM Rapid Test CE
Catalog: R0090C
OnSite HAV IgM Rapid Test Procedure
1 drop of
specimen
As easy as “1-2-3”
 Minimal training required
 No equipment needed
 Fast and reliable result in
15 minutes
 Can be used in any setting

1 drop of
sample diluent
Result
in 15 minutes!
CE
OnSite HAV IgM Rapid Test CE
Test Result Interpretation
Negative
No HAV Infection
Positive
Current infection or
late stage of infection
Invalid
Repeat test
OnSite HAV IgM Rapid Test CE
Performance
CTK HAV IgM Rapid Test
Reference
Positive
Negative
Total
Positive
21
1
22
Negative
0
178
178
Total
21
179
200
Only 15 minutes
to get results….
 Relative sensitivity: 95.5%
 Relative specificity: 100%
CTK HAV IgM ELISA Kit CE
Catalog: E0100
ADAPTABLE TO AUTOMATED SYSTEMS
CTK HAV IgM ELISA kit CE
Performance
CTK HAV IgM ELISA
Reference
Positive
Negative
Total
Positive
39
0
39
Negative
0
361
361
Total
39
361
400
Only 70 minutes
to get results….
 Relative sensitivity: 100%
 Relative specificity: 100%
OnSite HEV IgM Rapid Test CE
Catalog: R0095C
OnSite HEV IgM Rapid Test Procedure
1 drop of
specimen
As easy as “1-2-3”
 Minimal training required
 No equipment needed
 Fast and reliable results in
15 minutes
 Can be used in any setting

1 drop of
sample diluent
Result
in 15 minutes!
CE
OnSite HEV IgM Rapid Test Result
Test Result Interpretation
Negative
No HEV Infection
Positive
Current infection or
late stage of infection
Invalid
Repeat test
OnSite HEV IgM Rapid Test CE
Performance
CTK HEV IgM Rapid Test
Reference
Positive
Negative
Total
Positive
314
6
320
Negative
6
734
740
Total
320
740
1060
Only 15 minutes
to get results….
 Relative sensitivity: 98.1%
 Relative specificity: 99.2%
RecombiLISA HEV IgM ELISA Kit CE
Catalog: E0105
ADAPTABLE TO AUTOMATED SYSTEMS
RecombiLISA HEV IgM ELISA kit CE
Performance
CTK HEV IgM ELISA
Reference
Positive
Negative
Total
Positive
25
0
25
Negative
0
375
375
Total
25
375
400
Only 75 minutes
to get results….
 Relative sensitivity: 100%
 Relative specificity: 100%
Final Messages to Doctors

HAV and HEV seem similar BUT are clinically
different

HEV could be life threatening and requires
prompt action to prevent disease progression

HEV is often under diagnosed or misdiagnosed

Differential diagnosis of HEV and HAV is
clinically significant
Final Messages to Doctors
For easy, on site screening & differentiation of HAV & HEV
Order CTK Biotech’s
OnSite HAV IgM Rapid Test
Cat: R0090C
OnSite HEV IgM Rapid Test
Cat: R0095C
Final Messages to Doctors
For further confirmation & differentiation of HAV & HEV
Order CTK Biotech’s
HAV IgM ELISA kit
Cat: E0100C
HEV IgM ELISA kit
Cat: E0105C
Further information about
CTK HAV and HEV Test kits
Local distributor
CTK contact information:
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
San Diego, CA 92121, USA