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Clinical and Diagnostic Laboratory Immunology, July 2002, p. 840-845, Vol. 9, No. 4
1071-412X/02/$04.00+0     DOI: 10.1128/CDLI.9.4.840-845.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Evaluation of Urine as a Clinical Specimen for Diagnosis of Hepatitis A

Madhuri S. Joshi, Shobha D. Chitambar,* Vidya A. Arankalle, and Mandeep S. Chadha

Hepatitis Division, National Institute of Virology, Pune, 411 001 India

Received 24 September 2001/ Returned for modification 29 January 2002/ Accepted 2 April 2002

The present study pertains to the evaluation of urine as a specimen for detection of anti-hepatitis A virus (anti-HAV) antibodies. Immunoglobulin M (IgM), IgG, and IgA capture enzyme-linked immunosorbent assays for hepatitis A were performed on paired serum and urine specimens collected from hepatitis A patients (n = 92), healthy individuals (n = 100), non-A hepatitis patients (n = 70), and patients with nonhepatic diseases (n = 64, including 37 renal disease patients). Hepatitis A patients seropositive for anti-HAV IgM showed 95.65% uropositivity. No false-positive reactions were observed in control groups. The uropositivity of anti-HAV IgM persisted during the convalescent phase of the disease. Anti-HAV IgG uropositivity correlated well with corresponding seropositivity in all groups (P > 0.05 for each). No significant difference between the proportions of serum and urine positivity for anti-HAV IgA was noted (P > 0.05 for each). Using seroreactivity as a "gold standard," the sensitivity and specificity for anti-HAV IgM, anti-HAV IgG, and anti-HAV IgA tests with urine as a specimen were found to be 95.65 and 100%, 97.76 and 76.47%, and 92.23 and 88.18%, respectively. Urine appears to be comparable to serum for diagnosis of recent and past infection with hepatitis A.

* Corresponding author. Mailing address: Hepatitis Division, National Institute of Virology, 20-A, Dr. Ambedkar Rd., Pune 411 001, India. Phone: 91-20-612-7301. Fax: 91-20-612-2669. E-mail: chitambars{at}hotmail.com.

Clinical and Diagnostic Laboratory Immunology, July 2002, p. 840-845, Vol. 9, No. 4
1071-412X/02/$04.00+0     DOI: 10.1128/CDLI.9.4.840-845.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



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