Recombinant immunoblot assay reaction patterns and hepatitis C virus RNA in blood donors and non-A, non-B hepatitis patients.
To establish the value of the second-generation recombinant immunoblot assay (RIBA-2) and cDNA polymerase chain reaction (cDNA PCR) for confirmation of hepatitis C virus (HCV) infection, anti-HCV reaction patterns and the presence of HCV RNA were examined in 610 blood donors and 255 non-A, non-B hepatitis patients who were positive or indeterminate in RIBA-2. Of RIBA-2-positive donors (n = 191) and patients (n = 224), 75.4 and 89.7 percent, respectively, were HCV RNA positive. The most frequently observed anti-HCV recognition patterns in HCV RNA-positive donors and patients were c22, c33c, and c100 and/or 5-1-1 (67.3%, 57.7%) and c22, c33c (24.8%, 29.3%). Among subjects with a RIBA-2-indeterminate result, HCV RNA was detected more often in patients (n = 31) than in donors (n = 419): 67.7 and 2.1 percent, respectively. In viremic persons with single-band reactivity in RIBA-2, this reactivity was always directed against either c22 or c33c. HCV RNA was detected by cDNA PCR in none of 162 persons with only anti-c100 and/or anti-5-1-1 reactivity. Therefore, RIBA-2 reactivity against c100 in combination with 5-1-1 should not be considered positive but indeterminate. In RIBA-2-indeterminate persons, HCV RNA detection is necessary for reliable confirmation of HCV infection.
Bresters
D
D
Central Laboratory of the Netherlands, Red Cross Blood Transfusion Service, Amsterdam, The Netherlands.
Zaaijer
H L
HL
Cuypers
H T
HT
Reesink
H W
HW
Winkel
I N
IN
van Exel-Oehlers
P J
PJ
van Drimmelen
A A
AA
Jansen
P L
PL
van der Poel
C L
CL
Lelie
P N
PN
D001782:Blood Donors; D004247:DNA / Q000032:analysis; D004279:DNA, Viral / Q000032:analysis; D016174:Hepacivirus / Q000235:genetics* / Q000276:immunology; D006508:Hepatitis Antibodies / Q000097:blood; D006526:Hepatitis C / Q000097:blood*; D018937:Hepatitis C Antibodies; D006801:Humans; D015151:Immunoblotting / Q000379:methods*; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000097:blood*
D004279:DNA, Viral; D006508:Hepatitis Antibodies; D018937:Hepatitis C Antibodies; D012367:RNA, Viral; D004247:DNA