title: Confirmation of hepatitis C infection: a comparison of five immunoblot assays.
abstract: BACKGROUND
  Recently, new immunoblot assays for the detection of antibodies to hepatitis C virus (HCV) became available.
  
  
  METHODS
  The performance of five confirmatory anti-HCV immunoblot assays was studied with samples with known HCV antibody and HCV RNA status. The assays were a third-generation strip recombinant immunoblot assay (RIBA-3, Chiron Corp., Emeryville, CA), a second-generation HCV blot (DB-2 blot, Diagnostic Biotechnology, Singapore), the Wellcozyme HCV Western blot (Murex blot, Murex Diagnostics, Dartford, UK), an immunodot HCV assay (Matrix, Abbott Laboratories, Chicago, IL), and the third-generation HCV line immunoassay (Liatek-III, Organon Teknika, Boxtel, The Netherlands).
  
  
  RESULTS
  Sensitivity on samples from 48 HCV RNA-positive, second-generation RIBA (RIBA-2)-positive persons and specificity on samples from 31 low-risk donors was 96 percent or better for all assays. The sensitivity on 31 HCV RNA-positive, RIBA-2-indeterminate samples was as follows: Liatek-III, 94 percent; RIBA-3, 90 percent; Murex blot, 61 percent; Matrix, 55 percent; and DB-2 blot, 39 percent. In testing 39 HCV RNA-negative, RIBA-2-indeterminate donor samples, the percentage found to be negative was Liatek-III, 77 percent; RIBA-3, 67 percent; Murex blot, 49 percent; DB-2 blot, 33 percent; and Matrix, 15 percent. The order of sensitivity on four HCV seroconversion series was (from high to low): RIBA-3, Liatek-III, DB-2 blot, Murex blot, and Matrix; the differences were small.
  
  
  CONCLUSIONS
  Detection of HCV antibodies was not refined by the addition of new HCV antigens (NS5, E2/NS1), but by improved classical antigens (core, NS3, NS4). Replacement of the commonly used RIBA-2 will resolve the status of a high proportion of RIBA-2-indeterminate samples.
authors.affiliation: Viral Serology Department, Central Laboratory of the Netherlands Red Cross Blood Transfusion Service, Amsterdam.
authors.forename: H L
authors.initials: HL
authors.lastname: Zaaijer
authors.forename: H
authors.initials: H
authors.lastname: Vrielink
authors.forename: P J
authors.initials: PJ
authors.lastname: van Exel-Oehlers
authors.forename: H T
authors.initials: HT
authors.lastname: Cuypers
authors.forename: P N
authors.initials: PN
authors.lastname: Lelie
mesh_terms: D001782:Blood Donors; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006508:Hepatitis Antibodies / Q000032:analysis*; D006526:Hepatitis C / Q000175:diagnosis*; D018937:Hepatitis C Antibodies; D006801:Humans; D015151:Immunoblotting; D012367:RNA, Viral / Q000032:analysis / Q000097:blood
chemical_list: D006508:Hepatitis Antibodies; D018937:Hepatitis C Antibodies; D012367:RNA, Viral