| Abstract | Za virus hepatitisa E (HEV) karakteristično je da ga većina ljudi preboli asimptomatski. Ipak, za određene skupine kao
što su trudnice, pacijenti na imunosupresivnoj terapiji te za imunokompromitirane pojedince s već postojećim bolestima
jetre, HEV infekcija može dovesti do letalnog ishoda.Tijekom 16 mjeseci (2019. i 2020. godine), nešto više od 500
pacijenata serološki je ispitivano na biljege hepatitisa E u Hrvatskom zavodu za transfuzijsku medicinu (HZTM), i to u
Odjelu za dijagnostiku krvlju prenosivih bolesti (OKB). Korišteni su komercijalni HEV IgG Dia.Pro i HEV IgM Dia.Pro
testovi koji se temelje na ELISA metodi. Ispitivanja su obavljena na Gemini analizatoru i kompletan protokol pratio je
upute proizvođača. Obzirom na rezultate testiranja pacijenata (TP), HEV IgG seroprevalencija iznosi 23,2 % (117
uzoraka) dok je stopa HEV IgM seroprevalencije 9,3 % (47 uzoraka). HZTM još je 2014. godine proveo
seroprevalencijsku studiju koja je obuhvatila 1036 uzoraka dobrovoljnih darivatelja krvi (DDK). HEV seroprevalencija u
DDK-a procijenjena je s četiri dostupna testa (3 ELISA i 1 imunoblot (IB) test). Uspoređeni su rezultati dobiveni Dia.Pro
testom. HEV IgM seroprevalencija među TP statistički je značajno veća u odnosu na DDK (9,3 % naspram 4,4 %) što je
dokazano hi-kvadrat testom (χ2 test) uz razinu značajnosti testa α=0,05 (χ2=15,13 > χ2
df=1,α=0,05=3,84, p < 0,05). Ova veća
HEV IgM seroprevalencija može se objasniti činjenicom da je riječ o pacijentima kod kojih je liječnik posumnjao na HEV
infekciju. Rezultati ove studije pokazuju da je, ukoliko pacijent ima simptome virusnog hepatitisa, a uobičajeni uzročnici
su isključeni (HAV, HBV, HCV, EBV, CMV), preporučljiva serološka dijagnostika na biljege virusnog hepatitisa E.
Statistički značajna razlika nije primijećena kod HEV IgG seroprevalencije (23,2 % naspram 20,2 %, χ2=1,77 <
χ2
df=1,α=0,05=3,84, p > 0,05) što upućuje na zaključak da je HEV i naša autohtona infekcija. |
| Abstract (english) | The characteristic of hepatitis E virus (HEV) is that most people get over it asymptomatically. However, for certain
groups such as pregnant women, patients on immunosuppressive therapy and immunocompromised individuals with
pre-existing liver diseases, HEV infection can lead to a fatal outcome. During 16 months (2019 and 2020), slightly more
than 500 were serologically tested for hepatitis E markers at the Croatian Institute for Transfusion Medicine (CITM), in
the Department for Diagnostics of Blood Transmitted Diseases. Commercial HEV IgG Dia.Pro and HEV IgM Dia.Pro
tests were used. The principle of used method is ELISA. Tests were performed on Gemini analyzer and the complete
procedure followed the producer's instructions. Considering the results of patient testing (TP), the HEV IgG
seroprevalence is 23.2 % (117 samples) while the HEV IgM seroprevalence rate is 9.3 % (47 samples). In 2014, CITM
conducted a seroprevalence study that included 1036 samples from voluntary blood donors (VBD). HEV seroprevalence
in VBD was assessed with four available tests (3 ELISA and 1 immunoblot (IB) test). The results obtained with Dia.Pro
test were compared. HEV IgM seroprevalence among TP is significantly higher compared to VBD (9.3 % vs. 4.4 %) as
proven by the chi-square test (χ2 test) with a significance level of α=0.05 (χ2=15.13 > χ2
df=1,α=0.05=3.84, p < 0.05). This
higher HEV IgM seroprevalence can be explained by the fact that these are patients in whom the doctor suspected HEV
infection. The results of these studies show that, if the patient has symptoms of viral hepatitis, and the usual causative
agents are excluded (HAV, HBV, HCV, EBV, CMV), serological diagnosis for markers of viral hepatitis E is
recommended. No statistically significant difference was observed in HEV IgG seroprevalence (23.2 % vs. 20.2 %,
χ2=1.77 < χ2
df=1,α=0.05=3.84, p > 0.05) which leads to the conclusion that HEV is also our autochthonous infection. |
