title: Significance of highly positive c22-3 "indeterminate" second-generation hepatitis C virus (HCV) recombinant immunoblot assay (RIBA) and resolution by third-generation HCV RIBA.
abstract: Second-generation recombinant immunoblot assay (RIBA) is widely used for the validation of anti-hepatitis C virus (HCV) antibody detection. The aims of this work were (i) to determine, in terms of liver disease and HCV replication, the significance of a peculiar "indeterminate" second-generation RIBA pattern characterized by the presence of high titers of antibodies directed to c22-3, a protein bearing core epitopes and (ii) to determine whether a more advanced version of the same strip assay, namely a third-generation RIBA, may solve the problem of such indeterminate patterns. Sixty patients for which c22-3 indeterminate second-generation RIBAs were highly positive were studied. Forty-two of them (70%) were immunocompromised. Serum transaminases were increased in 46 cases (77%), and HCV RNA was detected by PCR in 50 cases (83%). Third-generation RIBA remained highly positive c22 indeterminate for 9 patients (15%) but was positive for 51 (85%), mostly because of increased sensitivity for the detection of both anti-c100 and anti-c33c antibodies. These results suggest that third-generation RIBA may achieve resolution of most of these cases but that highly positive c22 indeterminate third-generation RIBA may persist when used with some patients with very low titers of anti-HCV nonstructural protein antibodies.
authors.affiliation: Department of Bacteriology and Virology, Hôpital Henri Mondor, Université Paris XII, Creteil, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Pawlotsky
authors.forename: A
authors.initials: A
authors.lastname: Fleury
authors.forename: V
authors.initials: V
authors.lastname: Choukroun
authors.forename: L
authors.initials: L
authors.lastname: Deforges
authors.forename: F
authors.initials: F
authors.lastname: Roudot-Thoraval
authors.forename: P
authors.initials: P
authors.lastname: Aumont
authors.forename: J
authors.initials: J
authors.lastname: Duval
authors.forename: D
authors.initials: D
authors.lastname: Dhumeaux
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005189:False Positive Reactions; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification; D006508:Hepatitis Antibodies / Q000032:analysis*; D006526:Hepatitis C / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology; D018937:Hepatitis C Antibodies; D018936:Hepatitis C Antigens; D006801:Humans; D015151:Immunoblotting / Q000379:methods* / Q000706:statistics & numerical data; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D014758:Viral Core Proteins / Q000276:immunology
chemical_list: D006508:Hepatitis Antibodies; D018937:Hepatitis C Antibodies; D018936:Hepatitis C Antigens; D014758:Viral Core Proteins; C499352:core protein p22, Hepatitis C virus; C069130:nucleocapsid protein, Hepatitis C virus