title: Hepatitis C Virus Seroprevalence in Mongolian Women Assessed by a Novel Multiplex Antibody Detection Assay.
abstract: BACKGROUND
  Hepatitis C virus (HCV) infection causes hepatocellular carcinoma and is an important cause of mortality in both industrialized and developing countries. We developed a single-step high-throughput multiplex serology assay for HCV antibody detection and determined HCV prevalence in a highly endemic country.
  
  
  METHODS
  Five proteins (Core, NS3, NS4A, NS5A, NS5B) each from the three most common subtypes of HCV (1a, 1b, 2a) were recombinantly expressed and used as antigens in a multiplexed antibody detection assay. Multiplex HCV serology was validated with 432 reference sera whose HCV status was established by commercial ELISA, Western blot, and RNA assays. HCV antibodies were determined in 1,023 sera representative for the adult female population of Mongolia.
  
  
  RESULTS
  In reference sera, detection of HCV (mostly Core and NS3) antibodies by multiplex serology showed 100% sensitivity and 99.6% specificity, and was in very good agreement with the commercial diagnostic assays (kappa, 0.96; 95% confidence interval, 0.92-0.99). The role of antibodies to NS4 and NS5 remains to be evaluated. In Mongolia, overall HCV antibody prevalence was 18.9% (17.8% when age-standardized to the world population). HCV seroprevalence increased with age from 10% in women <30 years to 32% in women ≥50 years, but was not related to sexual risk factors.
  
  
  CONCLUSIONS
  The single-step high-throughput multiplex HCV serology assay performs similarly to conventional HCV antibody screening followed by secondary confirmation assays. A very high HCV seroprevalence was confirmed across all socio-economic groups in the female population of Mongolia.
  
  
  CONCLUSIONS
  Multiplex HCV serology facilitates large seroepidemiologic studies of HCV infection.
authors.affiliation: Infection and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany. International Agency for Research on Cancer, Lyon, France.
authors.forename: Bolormaa
authors.initials: B
authors.lastname: Dondog
authors.affiliation: Department of Infectious Diseases, Institute of Hygiene, University of Heidelberg, Heidelberg, Germany.
authors.forename: Paul
authors.initials: P
authors.lastname: Schnitzler
authors.affiliation: Infection and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Kristina M
authors.initials: KM
authors.lastname: Michael
authors.affiliation: International Agency for Research on Cancer, Lyon, France.
authors.forename: Gary
authors.initials: G
authors.lastname: Clifford
authors.affiliation: International Agency for Research on Cancer, Lyon, France.
authors.forename: Silvia
authors.initials: S
authors.lastname: Franceschi
authors.affiliation: Infection and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Pawlita
authors.affiliation: Infection and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany. T.Waterboer@dkfz-heidelberg.de.
authors.forename: Tim
authors.initials: T
authors.lastname: Waterboer
mesh_terms: D000328:Adult; D000367:Age Factors; D002352:Carrier Proteins / Q000276:immunology; D005260:Female; D018937:Hepatitis C Antibodies / Q000097:blood*; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D047908:Intracellular Signaling Peptides and Proteins; D008875:Middle Aged; D008986:Mongolia / Q000453:epidemiology; D015995:Prevalence; D012680:Sensitivity and Specificity; D016036:Seroepidemiologic Studies; D012698:Serologic Tests / Q000379:methods*; D014758:Viral Core Proteins / Q000276:immunology; D017361:Viral Nonstructural Proteins / Q000276:immunology; D012697:Serine Endopeptidases; D043583:Nucleoside-Triphosphatase; D053487:DEAD-box RNA Helicases; D000085242:Viral Proteases; D012324:RNA-Dependent RNA Polymerase
chemical_list: D002352:Carrier Proteins; D018937:Hepatitis C Antibodies; D047908:Intracellular Signaling Peptides and Proteins; D014758:Viral Core Proteins; D017361:Viral Nonstructural Proteins; C084422:NS3 protein, hepatitis C virus; D012697:Serine Endopeptidases; D043583:Nucleoside-Triphosphatase; D053487:DEAD-box RNA Helicases; D000085242:Viral Proteases; C455041:NS4A cofactor peptide, Hepatitis C virus; C069130:nucleocapsid protein, Hepatitis C virus; C087036:NS-5 protein, hepatitis C virus; D012324:RNA-Dependent RNA Polymerase