Antibody response to core, envelope and nonstructural hepatitis C virus antigens: comparison of immunocompetent and immunosuppressed patients.
Some immunosuppressed patients with hepatitis C virus infection do not have detectable levels of antibody to hepatitis C virus on second-generation enzyme immunoassay. Antibodies to the envelope and nonstructural region 5 proteins have not been examined. Four groups of patients with hepatitis C virus infection were studied: (a) 20 immunocompetent patients, (b) 15 hemodialysis patients, (c) 17 kidney transplant recipients and (d) 3 acute leukemia patients who underwent bone marrow transplantation. Serum samples were tested for antibody to hepatitis C virus with a second-generation enzyme immunoassay and multi-antigen enzyme immunoassays and for hepatitis C virus RNA with a nested polymerase chain reaction assay. All the immunocompetent patients reacted to C25, C22 and C33C; 90% reacted to nonstructural region 5 antigen and 80% reacted to C100-3. Only 55% reacted against yeast-derived e1 and e2 antigens, but all reacted against vaccinia virus--expressed N e1 and e2 antigens, indicating that the envelope epitopes are conformational and glycosylated. Sixty-five percent to 90% of dialysis and kidney transplant patients reacted to C25, C22 and N e1 and e2, but only 12% to 60% reacted to C100-3, C33C and nonstructural region 5 antigen. Diminution or loss of reactivity to hepatitis C virus antigens was observed after kidney and bone marrow transplantation, with C25 and N e1 and e2 less affected. Our data suggest that incorporation of C25 and N e1 and e2 antigens in the assay for antibody to hepatitis C virus would improve the detection of hepatitis C virus infection in immunosuppressed patients.
Lok
A S
AS
Department of Medicine, University of Hong Kong.
Chien
D
D
Choo
Q L
QL
Chan
T M
TM
Chiu
E K
EK
Cheng
I K
IK
Houghton
M
M
Kuo
G
G
D000917:Antibody Formation; D000956:Antigens, Viral / Q000276:immunology; D016026:Bone Marrow Transplantation / Q000276:immunology; D006679:HIV Seropositivity; D016174:Hepacivirus / Q000276:immunology*; D006508:Hepatitis Antibodies / Q000097:blood*; D006526:Hepatitis C / Q000276:immunology* / Q000635:transmission; D018937:Hepatitis C Antibodies; D006801:Humans; D007121:Immunocompetence; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation / Q000276:immunology; D007938:Leukemia / Q000601:surgery; D006435:Renal Dialysis; D065227:Transfusion Reaction; D014758:Viral Core Proteins / Q000276:immunology*; D014759:Viral Envelope Proteins / Q000276:immunology*; D017361:Viral Nonstructural Proteins / Q000276:immunology*
D000956:Antigens, Viral; C064544:C100 protein, hepatitis C virus; D006508:Hepatitis Antibodies; D018937:Hepatitis C Antibodies; D014758:Viral Core Proteins; D014759:Viral Envelope Proteins; D017361:Viral Nonstructural Proteins