High rate of chronicity in HCV infection determined by antibody confirmatory assay and PCR in 4110 patients during long-term follow-up.
BACKGROUND
It is still unclear how many patients with hepatitis C virus (HCV) antibodies have viremia and hence are infectious.


OBJECTIVE
To determine the chronicity of HCV infection by correlation of HCV antibodies with presence of viremia in long-term follow-up.


METHODS
In a longitudinal study sera of 4110 patients were analyzed with second generation HCV-enzyme immunoassay (EIA) and polymerase chain reaction (PCR). Only those patients were included in this study in whom sequential serum samples over a period of 2 years were available. To avoid preanalytical and analytical failures, we used a transport solution to prevent RNA degradation and a four-antigen recombinant immunoblot assay, established in our laboratory, for confirmation of antibody reactivity.


RESULTS
Of 2815 patients with confirmed HCV antibodies 2784 (98.9%) were also positive in HCV-PCR assay. False reactive EIA results were detected in 177 (13.7%) individuals as shown by confirmatory assay and PCR. Only one patient (0.04%) spontaneously lost detectable HCV viremia and subsequently HCV-specific antibodies.


CONCLUSIONS
Our study clearly demonstrates that presence of confirmed HCV-specific antibodies correlates significantly (98.9%; P < 0.001) with HCV viremia, and that spontaneous loss of viremia is a very rare event in HCV infection. We also found that elimination of HCV infection is not sufficiently predicted by the loss of detectable viremia in PCR, but can be concluded from the disappearance of virus-specific antibodies.
Institute of Medical Microbiology and Immunology, Universitätskrankenhaus Eppendorf (UKE), Hamburg, Germany.
H H
HH
Feucht
B
B
Zöllner
M
M
Schröter
S
S
Polywka
P
P
Buggisch
H
H
Nolte
R
R
Laufs
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005188:False Negative Reactions; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification; D018937:Hepatitis C Antibodies / Q000097:blood / Q000276:immunology*; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000821:virology*; D006801:Humans; D007231:Infant, Newborn; D016898:Interferon-alpha / Q000627:therapeutic use; D008137:Longitudinal Studies; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D013997:Time Factors; D014766:Viremia / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology / Q000821:virology
D018937:Hepatitis C Antibodies; D016898:Interferon-alpha