title: Immunologic events during the incubation period of hepatitis C virus infection: the role of antibodies to E2 glycoprotein. Multicentre Hemodialysis Cohort Study on Viral Hepatitis.
abstract: BACKGROUND
  The study of the sensitivity of screening assays is greatly facilitated by testing the sequential changes in seroconverting individuals. The aim of this study was to investigate the early immunologic response after hepatitis C virus (HCV) infection and to evaluate whether HCV envelope (E2) recombinant antigen would provide a significant increase in sensitivity for detection of anti-HCV.
  
  
  METHODS
  Twenty hemodialysis patients who were seroconverting to anti-HCV were included in this study. They were followed up for a mean period (+/- SD) of 10.5 +/- 3.3 months, in which 13 to 46 serum samples per case were collected. Each sample was tested for anti-HCV by second- and third-generation enzyme immunoassay (EIA-2 and EIA-3) and recombinant immunoblot assay (RIBA-3). E2 antibodies were tested by a prototype EIA in which E2 was expressed as a recombinant antigen in Chinese hamster ovary cells.
  
  
  RESULTS
  Alanine aminotransferase elevation was observed in 18 of 20 cases. Reactivity against c100, c33c, c22, NS5, and E2 was detected in 15 (75%), 19 (95%), 15 (75%), 2 (10%), and 17 (85%) patients, respectively; c33c was the most immunogenic antigen, followed in descending order by E2, c22, c100, and NS5. E2 antibody reactivity resolved the two RIBA-3-indeterminate cases. However, there was no case in which E2 reactivity preceded all other HCV antigens. Anti-E2 was found to react in all patients of genotypes 1a, 1b, and 3a but in only 2 of 4 patients of genotype 4a.
  
  
  CONCLUSIONS
  In this group of seroconverting individuals, E2 antigen was shown to be highly immunoreactive and did resolve some RIBA-3-indeterminate samples as being positive, on the basis of reactivity to multiple antigens, but it did not improve early detection of seroconversion.
authors.affiliation: Athens University Medical School, Greece.
authors.forename: M
authors.initials: M
authors.lastname: Psichogiou
authors.forename: A
authors.initials: A
authors.lastname: Katsoulidou
authors.forename: E
authors.initials: E
authors.lastname: Vaindirli
authors.forename: B
authors.initials: B
authors.lastname: Francis
authors.forename: S R
authors.initials: SR
authors.lastname: Lee
authors.forename: A
authors.initials: A
authors.lastname: Hatzakis
mesh_terms: D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000914:Antibodies, Viral / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000276:immunology; D006526:Hepatitis C / Q000235:genetics / Q000276:immunology*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D006435:Renal Dialysis; D012680:Sensitivity and Specificity; D013997:Time Factors; D014759:Viral Envelope Proteins / Q000276:immunology
chemical_list: D000914:Antibodies, Viral; D018937:Hepatitis C Antibodies; D012367:RNA, Viral; D014759:Viral Envelope Proteins; D000410:Alanine Transaminase