Hepatitis type E in a French population: detection of anti-HEV by a synthetic peptide-based enzyme-linked immunosorbent assay

Four synthetic peptides were used to develop an ELISA for detecting hepatitis type E infections. Antibodies to HEV were detected in 54 of 64 patients present during two outbreaks previously recognized as being due to hepatitis E virus. Those patients included French soldiers stationed in Chad at the time, and Algerian civilians residing in Algeria and considered as positive controls. Anti-HEV were also detected in 3 out of 74 cases of sporadic non-A, non-B, non-C hepatitis in France, and in 2 out of 150 anti-HAV-IgM-positive sporadic cases, also in France, but in none of 278 healthy adults from the general French population. Among a total of 34 anti-HEV-positive cases in French subjects, 32 were shown to be associated with travel outside of western Europe; in two cases, however, HEV transmission appeared to have taken place in Europe. Using this ELISA, a rapid drop in anti-HEV antibodies to undetectable levels following the acute phase of the disease was observed in a high proportion of the infected subjects. Thus, the present test would appear to be more suitable for diagnostic purposes than for epidemiological investigations.