ELISA in serodiagnosis of HCV infection

A high level of anti‐HCV is generally associated with viral replication and the number of recognized epitopes appears to be correlated with the viral charge. Nevertheless, the absence of detectable antibodies in about 60% of patients during the acute phase of the disease adn in 10% of chronically infected (generally immunocompromised subjects) are heavy handicaps for HCV serology. Moreover, low levels of anti‐HCV antibodies can persist after complete recovery, and HCV viremia does not appear to be associated with the presence of a special antibody specificity. The immunoblots presented as ‘confirmatory test’ always appear to be less sensitive that the screening tests adn therefore are unable to discriminate between post‐infection antibodies and false‐positive reactions, as rare as they can be. In these cases, as in non‐responder patients, PCR appears essential. The possible reasons of immune response limitations and the possible improvements of HCV serology are discussed.