Recombinant immunoblot assay reaction patterns and hepatitis C virus RNA in blood donors and non-A, non-B hepatitis patients

• Published in: Transfusion (Philadelphia, Pa.) Vol. 33; no. 8; p. 634
• Main Authors: Bresters, D, Zaaijer, H L, Cuypers, H T, Reesink, H W, Winkel, I N, van Exel-Oehlers, P J, van Drimmelen, A A, Jansen, P L, van der Poel, C L, Lelie, P N
• Format: Journal Article
• Language: English
• Published: United States 01-08-1993
• Subjects: Blood Donors; DNA - analysis; DNA, Viral - analysis; Hepacivirus - genetics; Hepacivirus - immunology; Hepatitis Antibodies - blood; Hepatitis C - blood; Hepatitis C Antibodies; Humans; Immunoblotting - methods; Polymerase Chain Reaction; RNA, Viral - blood
• ISSN: 0041-1132
• DOI: 10.1046/j.1537-2995.1993.33893342743.x

To establish the value of the second-generation recombinant immunoblot assay (RIBA-2) and cDNA polymerase chain reaction (cDNA PCR) for confirmation of hepatitis C virus (HCV) infection, anti-HCV reaction patterns and the presence of HCV RNA were examined in 610 blood donors and 255 non-A, non-B hepatitis patients who were positive or indeterminate in RIBA-2. Of RIBA-2-positive donors (n = 191) and patients (n = 224), 75.4 and 89.7 percent, respectively, were HCV RNA positive. The most frequently observed anti-HCV recognition patterns in HCV RNA-positive donors and patients were c22, c33c, and c100 and/or 5-1-1 (67.3%, 57.7%) and c22, c33c (24.8%, 29.3%). Among subjects with a RIBA-2-indeterminate result, HCV RNA was detected more often in patients (n = 31) than in donors (n = 419): 67.7 and 2.1 percent, respectively. In viremic persons with single-band reactivity in RIBA-2, this reactivity was always directed against either c22 or c33c. HCV RNA was detected by cDNA PCR in none of 162 persons with only anti-c100 and/or anti-5-1-1 reactivity. Therefore, RIBA-2 reactivity against c100 in combination with 5-1-1 should not be considered positive but indeterminate. In RIBA-2-indeterminate persons, HCV RNA detection is necessary for reliable confirmation of HCV infection.