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Antibody response to core, envelope and nonstructural hepatitis C virus antigens: Comparison of immunocompetent and immunosuppressed patients
Author(s) -
Lok Anna S. F.,
Chien David,
Choo QuiLim,
Chan TakMao,
Chiu Edmond K. W.,
Cheng Ignatius K. P.,
Houghton Michael,
Kuo George
Publication year - 1993
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840180305
Subject(s) - virology , antigen , hepatitis c virus , virus , antibody , epitope , immunoassay , hepatitis b virus , hepatitis , medicine , immunology , biology
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 multiantigen 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. (HEPATOLOGY 1993;18:497–502.)