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Screening for leptospirosis or a toxic etiology was carried out and the risk of including such patients eliminated.

Patients with HBsAg and anti-HCV antibodies were not included in the study, although co-infection in asymptomatic HBV carriers or subsequent infection in patients who had recovered from a past HCV infection remained possible. There was a risk that some patients with late appearance of anti-HCV antibodies were included since PCR tests could not be performed.

Cytomegalovirus or Epstein-Barr virus was not involved, since no specific IgMs against these viruses were detectable.

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Large discrepancies between the two commercial enzyme-linked immunosorbent assays ELISAs available for serological diagnosis of hepatitis E Abbott and Genelabs were observed. Among the 53 sera screened using both tests, only 20 gave positive results in both, and all such sera were confirmed using a domestic immunological test involving inhibition of labelled, well-documented anti-HEV-specific human IgG.

Immunological confirmation was obtained for only half of the sera with discordant results in the commercial ELISAs. Bull World Health Organ. PMID: Rioche , P.


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