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Hepatitis C as the cause of chronic non‐A, non‐B hepatitis: High sensitivity of simultaneous measurement of core and non‐structural antibodies
Author(s) -
LIN R.,
YATUHASHI H.,
YANO M.,
FARRELL G. C.
Publication year - 1992
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.1992.tb01020.x
Subject(s) - medicine , antibody , serology , virology , hepatitis c virus , virus , hepatitis , viral disease , hepatitis b virus , immunology
First generation serologic tests (ELISA‐1) for hepatitis C virus infection measure antibodies directed against a short non‐structural segment of the virus (anti‐c100‐3). A major disadvantage of this test is that it lacks sensitivity in the identification of hepatitis C virus among patients at risk of infection. Thus, only 70–90% of chronic non‐A, non‐B cases are ELISA‐1 positive. The present study set out to determine whether antibodies directed against the core region would be a more sensitive indicator of hepatitis C virus infection in patients with chronic non‐A, non‐B hepatitis. Sera were studied from 97 patients with raised serum alanine aminotransferase levels for more than 6 months in whom other causes of abnormal alanine aminotransferase were excluded. Using ELISA‐1, 85 sera (87%) were anti‐c100‐3 positive. Sera were then tested for presence of antibody directed against Po, a core peptide of a Japanese strain of hepatitis C virus, using an ELISA method. Eighty‐eight sera (91%) were anti‐Po positive. Among the 12 anti‐c100‐3 negative patients, six were anti‐Po positive. A second generation ELISA for anti‐HCV (ELISA‐2) incorporates a different antibody to the core region (c22‐3) in addition to an expanded non‐structural region, c200, which consists of c100‐3 plus c33c. With these tests, all sera but one were positive, including 11 of 12 ELISA‐1 negative and eight of nine anti‐Po negative sera. It is concluded that most patients considered to have chronic non‐A, non‐B hepatitis on exclusion and risk factor criteria have one or more markers of hepatitis C virus infection. Individual antibody tests against core or non‐structural regions appear to have similar sensitivities (85–90%), but the results supplement each other. Thus, the sensitivity of a commercially available second generation ELISA test (which combines one core and two non‐structural antibodies) approached 100% in this study and represents a major advance in the diagnosis of hepatitis C.