Immunohistochemistry for hepatitis E virus capsid protein cross-reacts with cytomegalovirus-infected cells: a potential diagnostic pitfall.

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Version: Author's accepted manuscript
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Serval ID
serval:BIB_27C183206471
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Immunohistochemistry for hepatitis E virus capsid protein cross-reacts with cytomegalovirus-infected cells: a potential diagnostic pitfall.
Journal
Histopathology
Author(s)
Lenggenhager D., Grossmann J., Gouttenoire J., Sempoux C., Weber A.
ISSN
1365-2559 (Electronic)
ISSN-L
0309-0167
Publication state
Published
Issued date
01/2023
Peer-reviewed
Oui
Volume
82
Number
2
Pages
354-358
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Immunohistochemistry for hepatitis E virus (HEV) ORF2 (capsid) protein is a powerful tool for tissue-based diagnosis of hepatitis E, particularly useful in evaluating abnormal liver values in immunocompromised patients. We report here a previously unobserved reactivity of the HEV ORF2 antibody to human cytomegalovirus (CMV) proteins and contrast the staining patterns encountered in HEV and CMV infection, respectively. As part of a routine diagnostic work-up, the liver biopsy of an immunocompromised patient with elevated liver values was examined histologically for infection with viruses including CMV and HEV. Cytopathic changes were found, suggestive of CMV infection, which was confirmed by immunohistochemistry. Surprisingly, reactivity of a portion of CMV-infected cells with a mouse monoclonal antibody (clone 1E6) against HEV ORF2 protein was also detected. This observation prompted a screening of 22 further specimens (including liver, gastrointestinal, lung, brain and placental biopsies) with confirmed CMV infection/reactivation. Immunoreactivity of CMV-infected cells with HEV ORF2 antibody was observed in 18 of 23 specimens. While the HEV ORF2 antibody showed cytoplasmic, nuclear and canalicular positivity in hepatitis E cases, positivity in CMV-infected cells was limited to the nucleus. In conclusion, the HEV ORF2 antibody (clone 1E6) shows unexpected immunoreactivity against CMV proteins. In contrast to the hepatitis E staining pattern with cytoplasmic, nuclear and occasional canalicular positivity, reactivity in CMV-infected cells is restricted to the nucleus. Awareness of this cross-reactivity and knowledge of the differences in staining patterns will prevent pathologists from misinterpreting positive HEV ORF2 immunohistochemistry in liver specimens.
Keywords
Pregnancy, Animals, Mice, Humans, Female, Hepatitis E virus, Cytomegalovirus, Capsid Proteins, Hepatitis E, Placenta, HEV ORF2 antibody, cross-reactivity, cytomegalovirus (CMV) antibody, hepatitis E virus (HEV), immunohistochemistry
Pubmed
Web of science
Create date
26/09/2022 8:36
Last modification date
28/12/2022 7:52
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