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Second‐Generation Hepatitis C Elisa Antibody Tests Confirmed by the Four‐Antigen Recombinant Immunoblot Assay Correlate Well with Hepatitis C Viremia and Chronic Liver Disease in Swedish Blood Donors
Author(s) -
Shev S.,
Foberg U.,
Fryden A.,
Hermodsson S.,
Lindh G.,
Lindholm A.,
Månsson A.S.,
Sydow M.,
Weiland O.,
Widell A.,
Norkrans G.
Publication year - 1993
Publication title -
vox sanguinis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.68
H-Index - 83
eISSN - 1423-0410
pISSN - 0042-9007
DOI - 10.1111/j.1423-0410.1993.tb04521.x
Subject(s) - medicine , viremia , antibody , hepatitis , virology , chronic liver disease , recombinant dna , polymerase chain reaction , hepatitis c , liver disease , immunology , gastroenterology , biology , gene , cirrhosis , biochemistry
Seventy‐three Swedish blood donors (52 men, 21 women; median age 36 years) repeatedly reactive for hepatitis C antibodies (anti‐HCV C‐100‐3) were tested with a second‐generation (2 nd ‐gen) anti‐HCV Elisa and a 4‐band recombinant immunoblot assay (RIBA 2). These results were correlated to serum alanine aminotransferase (S‐ALAT), liver morphology and viremia as detected by ‘nested’ polymerase chain reaction (PCR) based on primers from a 5′‐noncoding sequence of the HCV genome. Thirty‐five of 46 (76%) donors with positive 2 nd ‐gen Elisa tests confirmed by RIBA 2 were PCR positive whereof 27 had histological findings compatible with chronic persistent hepatitis (CPH) and 7 had chronic active hepatitis (CAH). Ten of 56 (18%) 2 nd ‐gen Elisa‐positive donors were RIBA 2 negative (or indeterminate) and none of these had chronic hepatitis nor were PCR positive. Seventeen of 73 (23%) donors were 1 st ‐gen Elisa positive but 2 nd ‐gen Elisa negative. All of these were PCR negative and only 1 (6%) had chronic hepatitis (CPH). An elevated S‐ALAT level (reference <0.7 μkat/1) was found in 26 2 nd ‐gen Elisa and RIBA 2‐positive donors of which 18 had CPH and 7 had CAH and all 25 were PCR positive. A normal S‐ALAT level was found in 9 of 34 (26%) donors with chronic hepatitis (all had CPH) and positive PCR. We have found that blood donors with positive 2 nd ‐gen anti‐HCV Elisa tests confirmed by RIBA‐2 and especially with a concomitant elevated S‐ALAT are highly likely to be viremic as demonstrated by PCR and to have chronic hepatitis.