Hepatitis E virus is an emerging concern in immunocompromised patients, who may become chronically infected. This prompted us to assess the performance of two anti-HEV
IgG and
IgM assays for diagnosing acute HEV
infections. The specificities of the assays were estimated by testing samples from 2 to 3 year-old French children and blood donors and their sensitivities by testing 40 immunocompromised patients acutely infected. Both anti-HEV
IgM assays were highly specific (99.6% and 100%). The sensitivity of the Adaltis was 87.5%, and that of Wantai was 85%. The specificities of anti-HEV
IgG Wantai (97.8%) and Adaltis tests (89.5%, p=0.1) were similar but the Wantai test was more sensitive (45%) than the Adaltis test (15%, p<0.001). None of the samples was anti-HEV
IgM negative and
IgG positive. We conclude that these anti-HEV
IgM assays performed well in immunosuppressed subjects with acute
hepatitis E and can be used as first line virological tools. Testing for anti-HEV
IgG and
IgM simultaneously at the acute phase did not improve the diagnostic performance. In contrast, molecular detection of HEV
RNA appears essential to exclude an HEV
infection in patients who are negative for anti-HEV
IgM and to assess the evolution of
hepatitis E 3 months thereafter.