Second-generation hepatitis C Elisa antibody tests confirmed by the four-antigen recombinant immunoblot assay correlate well with hepatitis C viremia and chronic liver disease in Swedish blood donors.
Seventy-three Swedish blood donors (52 men, 21 women; median age 36 years) repeatedly reactive for hepatitis C antibodies (anti-HCV C-100-3) were tested with a second-generation (2nd-gen) anti-HCV Elisa and a 4-band recombinant immunoblot assay (RIBA 2). These results were correlated to serum alanine aminotransferase (S-ALAT), liver morphology and viremia as detected by 'nested' polymerase chain reaction (PCR) based on primers from a 5'-noncoding sequence of the HCV genome. Thirty-five of 46 (76%) donors with positive 2nd-gen Elisa tests confirmed by RIBA 2 were PCR positive whereof 27 had histological findings compatible with chronic persistent hepatitis (CPH) and 7 had chronic active hepatitis (CAH). Ten of 56 (18%) 2nd-gen Elisa-positive donors were RIBA 2 negative (or indeterminate) and none of these had chronic hepatitis nor were PCR positive. Seventeen of 73 (23%) donors were 1st-gen Elisa positive but 2nd-gen Elisa negative. All of these were PCR negative and only 1 (6%) had chronic hepatitis (CPH). An elevated S-ALAT level (reference < 0.7 mu kat/l) was found in 26 2nd-gen Elisa and RIBA 2-positive donors of which 18 had CPH and 7 had CAH and all 25 were PCR positive. A normal S-ALAT level was found in 9 of 34 (26%) donors with chronic hepatitis (all had CPH) and positive PCR. We have found that blood donors with positive 2nd-gen anti-HCV Elisa tests confirmed by RIBA-2 and especially with a concomitant elevated S-ALAT are highly likely to be viremic as demonstrated by PCR and to have chronic hepatitis.
Shev
S
S
Department of Infectious Diseases, Ostra Hospital, Göteborg, Sweden.
Foberg
U
U
Fryden
A
A
Hermodsson
S
S
Lindh
G
G
Lindholm
A
A
Månsson
A S
AS
von Sydow
M
M
Weiland
O
O
Widell
A
A
D000328:Adult; D000956:Antigens, Viral / Q000097:blood*; D001483:Base Sequence; D001782:Blood Donors; D002908:Chronic Disease; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016174:Hepacivirus / Q000276:immunology / Q000302:isolation & purification*; D006508:Hepatitis Antibodies / Q000097:blood*; D006526:Hepatitis C / Q000382:microbiology*; D018937:Hepatitis C Antibodies; D006801:Humans; D015151:Immunoblotting / Q000379:methods; D008107:Liver Diseases / Q000382:microbiology*; D008297:Male; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D013548:Sweden; D017361:Viral Nonstructural Proteins / Q000276:immunology; D014766:Viremia / Q000175:diagnosis*
D000956:Antigens, Viral; C064544:C100 protein, hepatitis C virus; D006508:Hepatitis Antibodies; D018937:Hepatitis C Antibodies; D017361:Viral Nonstructural Proteins