HEPATITIS C VIRUS (HCV) VIREMIA IN PATIENTS WITH INDETERMINATE SECOND-GENERATION HCV RECOMBINANT IMMUNOBLOT ASSAY

摘要

Positivity of recombinant immunoblot assay (RIBA 2) for detection of antibodies tf> Hepatitis C virus (anti-HCV) is usually associated with HCVviremia. The significance of an indeterminate RIB A result defined by reactivity to only one HCV antigen ismore problematic. The aim of this study was to determine: 1) the prevalence of RIB A indeterminate subjects, and 2) the correlation between RIB A indeterminate result and viremia according to the presence of normal or increased alanine aminotransferase (ALT) levels. In all RIB A 2 indeterminate subjects HCV RNA was detected by reverse transcription polymerase chain reaction (RT-PCR), and serum ALT was measured. An indeterminate RIB A 2 was found in 30 (15.15%) of subjects. Comparing the distribution ofindividual reactivity to HCV antigens (c22-3, c33c, c100-3 and 5-1-1) we found the reactivity to c22-3 to be the most frequent (p<0.001). Of 30 RIBA indeterminate subjects HCV RNA was detected in 19 (63,3%) of which 15 (78,9%) were anti-c22-3-positive. Analysing of RNA positivity according to ALT levels, we found that all the patients with elevated ALT and 15.3% of those with normal ALT levels were HCV RNA positive. We have found a significant correlation between viremia and elevated ALT levels. This study demonstrated that HCVviremia was frequent in subjects with indeterminate RIBA, especially in those with increased ALT levels.