Hepatitis E: the West of Scotland experience

Hepatitis E virus is traditionally regarded as a virus of the developing world and is emerging as a leading cause of non-A/B/C hepatitis. We wished to investigate locally acquired transmission of hepatitis E in the West of Scotland and compare our use of traditional serology versus polymerase chain reaction since the introduction of polymerase chain reaction in 2007.

Clinical details provided on specimens of blood positive for hepatitis E virus by serology or polymerase chain reaction were collated and analysed.

Since 2007, 30 samples were hepatitis E virus-positive by serology or polymerase chain reaction. Polymerase chain reaction positivity was generally associated with positive serology although four samples were polymerase chain reaction-negative and strongly positive by serology. Interestingly, one-quarter of cases were likely to represent endogenous transmission of the infection.

Polymerase chain reaction is valuable in reliably diagnosing hepatitis E virus. However, serology is valuable for diagnosing resolved infection. There may be a high level of undiagnosed locally acquired hepatitis E virus in Scotland.