CD40LG and Acute hepatitis: However, the study conducted by Huang et al. observed that about 3% of acute hepatitis cases (defined as acute liver damage evidenced by a 2.5 fold upper limit of the normal level of alanine aminotransferase) were negative for anti-HEV IgM (using the Wantai kit) but had a 4-fold rise in anti-HEV IgG in their convalescent sera [53], which indicates an acute HEV infection [55–57].