National Health and Nutrition Examination Survey

IgG and IgM hepatitis E virus (HEV) antibody testing of stored sera specimens from NHANES III was conducted to estimate the seroprevalence of HEV infection (anti-HEV IgG and IgM) in participants ≥ 6 years of age.

A stratified random sample of participants ≥6 years of age from NHANES III with anti-HEV IgG test results from testing performed by Kuniholm et al. was selected for testing by the CDC Hepatitis Laboratory.

Anti-HEV (IgG)
DS-EIA-ANTI-HEV-G is an enzyme immunoassay kit intended for the detection of IgG antibodies to hepatitis E virus in human serum or plasma. During an initial incubation, HEV antibody in the sample binds with HEV antigen coated onto wells of a polystyrene stripped plate. Unbound sample is removed by washing. During a second incubation, horseradish peroxidase-labeled antibody conjugate (monoclonal mouse antibodies against human IgG) binds to any human IgG from the sample that was captured on the well. Unbound conjugate is removed by washing and a substrate solution containing tetramethylbenzidine is added to produce color. The reaction is stopped by adding a sulphuric acid solution and the OD of each well is read. The presence or absence of IgG antibodies to hepatitis E virus is determined by the ratio of the OD of each sample to the calculated cut-off value. A sample is considered negative if the sample OD value is < cut-off and is considered positive if the sample OD value is ≥ cut-off.

Anti-HEV (IgM)
DS-EIA-ANTI-HEV-M is an enzyme immunoassay kit intended for the detection of IgM antibodies to hepatitis E virus in human serum or plasma. During an initial incubation, HEV antibody in the sample binds with HEV antigen coated onto wells of a polystyrene stripped plate. Unbound sample is removed by washing. During a second incubation, horseradish peroxidase-labeled antibody conjugate (monoclonal mouse antibodies against human IgM) binds to any human IgM from the sample that was captured on the well. Unbound conjugate is removed by washing and a substrate solution containing tetramethylbenzidine is added to produce color. The reaction is stopped by adding a sulphuric acid solution and the OD of each well is read.The presence or absence of IgM antibodies to hepatitis E virus is determined by the ratio of the OD of each sample to the calculated cut-off value. A sample is considered negative if the sample OD value is < cut-off and is considered positive if the sample OD value is ≥ cut-off.

Data was received after all the laboratory testing was complete. The data were not edited.

Data Access: All data are publicly available.

The NHANES quality assurance and quality control (QA/QC) protocols meet the 1988 Clinical Laboratory Improvement Act mandates.

There are three variables:
SEQN: Respondent sequence number
SSHEG: Anti-HEV IgG (1=Positive, 2=Negative)
SSHEM: Anti-HEV IgM (1=Positive, 2=Negative)