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Is it possible to diagnose acute hepatitis C virus (HCV) infection by a rising anti‐HCV titre rather than by seroconversion?
Author(s) -
Lu S.N.,
Tung H.D.,
Chen T.M.,
Lee C.M.,
Wang J.H.,
Hung C.H.,
Chen C.H.,
Changchien C.S.
Publication year - 2004
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/j.1365-2893.2004.00533.x
Subject(s) - seroconversion , medicine , hepatitis c virus , titer , gastroenterology , hepatitis c , exacerbation , antibody , immunology , virology , hepatitis , virus
Summary. The diagnosis of acute hepatitis C virus (HCV) infection relies on documented positive‐seroconversion of HCV antibody (anti‐HCV). Because of the detection of seroconversion at an earlier stage by second or third generation anti‐HCV enzyme immunoassays (EIA), the diagnosis of acute hepatitis C (AHC) may be underestimated. The aim of this study was to evaluate whether rising anti‐HCV titre could be used to diagnose AHC or not. Eighteen patients with a clinical diagnosis of acute hepatitis C were enrolled, including eight cases with documented seroconversion to anti‐HCV and 10 cases with clinically suspected acute hepatitis C. Four chronic hepatitis C patients with acute exacerbation were selected as a control group. Serial sera were assayed with a third generation anti‐HCV (AxSYM, version 3.0; Abbott, Chicago, IL, USA) and recombinant immunoblot assays (RIBA; Chiron HCV 3.0 Strip; Immunoblot, Emeryville, CA, USA) and the titre of anti‐HCV expressed as signal/cutoff (S/CO) ratio and the RIBA patterns were correlated. Seven of eight documented AHC (one lacking the initial serum) and five of 10 clinically suspected AHC showed a rising pattern of S/CO values. The initial S/CO values on the first visit were less than 40 in 14 of 18 cases. The RIBA pattern shifted from negative/indeterminate to positive in five of seven documented AHC and 4 of 10 clinically suspected AHC cases. Fifteen of 18 cases had seroconversions of at least one antibody, whilst 85.7% showed a rising S/CO ratio. On the contrary, the S/CO ratio and RIBA pattern remained unaltered in chronic hepatitis C with acute exacerbation. The rise in S/CO was usually accompanied with an increase in the number of RIBA reactive bands and their intensity in acute hepatitis C patients. The rise in S/CO ratios using a third generation anti‐HCV assay and the RIBA pattern might be used as a supplemental diagnostic criterion for acute HCV infection.