What this test measures
Anti-HEV IgG is the immunoglobulin-G antibody that develops as acute hepatitis E resolves. It typically appears 2–6 weeks after exposure (often after IgM) and persists for years to decades, providing long-lasting protection against re-infection.
In most Indian adults, anti-HEV IgG seroprevalence ranges from 15% to over 50% depending on region and age — reflecting widespread past exposure to contaminated water. A positive IgG with negative IgM indicates past infection and immunity; both positive indicates recent acute infection.
Why it matters
In acute jaundice, anti-HEV IgG is interpreted alongside anti-HEV IgM. IgM alone tells you about acute illness; IgG tells you about past exposure. Both together help with timing — both positive means the infection is in the convalescent phase.
Anti-HEV IgG is also used in seroprevalence studies (used by ICMR and NIV Pune to map HEV exposure across Indian states), in pre-travel medicine, in screening blood donors in some research settings, and in transplant or immunosuppressed patients before therapy. It is not a routine standalone diagnostic test.
How to prepare
No fasting required. The test can be done at any time of day.
Markers & reference ranges
Reference ranges below are typical adult values. Your lab's reported range may differ slightly based on the assay platform and patient demographics — always read your report against the range printed on it.
| Marker | Normal range | If low | If high |
|---|---|---|---|
| Anti-HEV IgG (Index / Reactive-Non-reactive)[1][2] | Reactive in past exposure | Non-reactive — no past HEV exposure. Susceptible to first infection. Common in young children and people with no prior water contamination exposure. | Reactive — past or recent HEV exposure. Combined with IgM-negative = past infection (immune). Combined with IgM-positive = recent acute infection in convalescence. |
Anti-HEV IgM and IgG — clinical interpretation
| Anti-HEV IgM | Anti-HEV IgG | Interpretation |
|---|---|---|
| Positive | Positive | Recent acute hepatitis E (convalescent phase). |
| Positive | Negative | Very early acute hepatitis E — IgG will rise. |
| Negative | Positive | Past infection — immune. |
| Negative | Negative | Never exposed — susceptible. |
Frequently asked questions
My anti-HEV IgG is positive but IgM is negative. Should I worry?
No. This pattern means past hepatitis E infection with long-lasting immunity. No treatment is needed.
How long does anti-HEV IgG last?
Years to decades. Long-term studies suggest IgG persists for at least 10–20 years, possibly lifelong, after natural infection.
Can I get hepatitis E again if I am IgG positive?
Reinfection is uncommon. IgG provides strong but not absolute protection. Severe symptomatic reinfection is rare.
Is IgG useful in diagnosing acute hepatitis E?
IgG by itself is not enough — anti-HEV IgM is the diagnostic marker for acute infection. IgG adds timing context.
Why is IgG seroprevalence so high in India?
HEV is widespread through contaminated water. Most Indian adults are exposed at some point. Seroprevalence varies from 15% to over 50% depending on region.
Does the hepatitis E vaccine produce IgG?
Yes — the HEV 239 vaccine (licensed in China, not widely available in India) produces protective anti-HEV IgG. Indian patients rely on natural exposure for immunity.
Should I get vaccinated if my IgG is negative?
There is no widely available HEV vaccine in India. Prevention currently relies on safe drinking water — boiled or bottled water during outbreaks.
Related Hepatitis tests
Tests commonly ordered alongside HEPATITIS E VIRUS IGG, or that help interpret an unexpected result.
Sources & references
- CDC — Hepatitis E · accessed 2026-05-30T00:00:00.000Z
- WHO — Hepatitis E Fact Sheet · accessed 2026-05-30T00:00:00.000Z
- INASL — Acute Viral Hepatitis Consensus · accessed 2026-05-30T00:00:00.000Z
- NIH NIAID — Hepatitis E · accessed 2026-05-30T00:00:00.000Z
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