Abstract
Between April 1993 and March 1995, 429 of 334,454 (0.13%) blood donations at the Toronto Centre of the Canadian Red Cross were reactive for hepatitis C virus (HCV) by second-generation enzyme immunoassay (EIA-2). Of the 429 EIA-2-positive donations, 189 (44%), 138 (32%), and 102 (24%) were positive, indeterminate, and negative by Second-Generation Recombinant Immunoblot Assay (RIBA-2). To assess HCV viremia and minimize the risk that specimen handling affected PCR-based detection, the qualitative AMPLICOR HCV test was performed on both pilot tube sera (PTS) and the corresponding fresh frozen plasma (FFP) from 294 EIA-2-reactive donations. AMPLICOR PCR results for PTS and FFP were 100% concordant and were confirmed by nested HCV PCR for 27 of 294 donations. The AMPLICOR HCV test was positive for 127 of 140 (91%) of RIBA-2-positive donations (81, 91, and 96% of donations with two, three, and four reactive bands, respectively), 5 of 88 (5.7%) indeterminate donations, and 0 of 66 (0%) RIBA-2-negative donations. The Third-Generation Recombinant Immunoblot Assay (RIBA-3) was performed on RIBA-2-negative, -indeterminate, and -positive, PCR-negative donations. RIBA-3 demonstrated enhanced specificity and resolved 18 of 88 (20%) of RIBA-2-indeterminate samples as HCV antibody positive. The study demonstrates that PTS are as suitable as FFP for PCR-based detection of HCV and can be used to determine if EIA-2-reactive blood donors are viremic at the time of donation.
Full Text
The Full Text of this article is available as a PDF (172.0 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Alter M. J., Margolis H. S., Krawczynski K., Judson F. N., Mares A., Alexander W. J., Hu P. Y., Miller J. K., Gerber M. A., Sampliner R. E. The natural history of community-acquired hepatitis C in the United States. The Sentinel Counties Chronic non-A, non-B Hepatitis Study Team. N Engl J Med. 1992 Dec 31;327(27):1899–1905. doi: 10.1056/NEJM199212313272702. [DOI] [PubMed] [Google Scholar]
- Barrera J. M., Francis B., Ercilla G., Nelles M., Achord D., Darner J., Lee S. R. Improved detection of anti-HCV in post-transfusion hepatitis by a third-generation ELISA. Vox Sang. 1995;68(1):15–18. doi: 10.1111/j.1423-0410.1995.tb02538.x. [DOI] [PubMed] [Google Scholar]
- Bukh J., Wantzin P., Krogsgaard K., Knudsen F., Purcell R. H., Miller R. H. High prevalence of hepatitis C virus (HCV) RNA in dialysis patients: failure of commercially available antibody tests to identify a significant number of patients with HCV infection. Copenhagen Dialysis HCV Study Group. J Infect Dis. 1993 Dec;168(6):1343–1348. doi: 10.1093/infdis/168.6.1343. [DOI] [PubMed] [Google Scholar]
- Busch M. P., Tobler L., Quan S., Wilber J. C., Johnson P., Polito A., Steane E., Zola A., Bahl C., Nelles M. A pattern of 5-1-1 and c100-3 only on hepatitis C virus (HCV) recombinant immunoblot assay does not reflect HCV infection in blood donors. Transfusion. 1993 Jan;33(1):84–88. doi: 10.1046/j.1537-2995.1993.33193142316.x. [DOI] [PubMed] [Google Scholar]
- Busch M. P., Wilber J. C., Johnson P., Tobler L., Evans C. S. Impact of specimen handling and storage on detection of hepatitis C virus RNA. Transfusion. 1992 Jun;32(5):420–425. doi: 10.1046/j.1537-2995.1992.32592327714.x. [DOI] [PubMed] [Google Scholar]
- Craxì A., Valenza M., Fabiano C., Magrin S., Fiorentino G., Diquattro O., Pagliaro L. Third-generation hepatitis C virus tests in asymptomatic anti-HCV-positive blood donors. J Hepatol. 1994 Nov;21(5):730–734. doi: 10.1016/s0168-8278(94)80231-9. [DOI] [PubMed] [Google Scholar]
- Cuthbert J. A. Hepatitis C: progress and problems. Clin Microbiol Rev. 1994 Oct;7(4):505–532. doi: 10.1128/cmr.7.4.505. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cuypers H. T., Bresters D., Winkel I. N., Reesink H. W., Weiner A. J., Houghton M., van der Poel C. L., Lelie P. N. Storage conditions of blood samples and primer selection affect the yield of cDNA polymerase chain reaction products of hepatitis C virus. J Clin Microbiol. 1992 Dec;30(12):3220–3224. doi: 10.1128/jcm.30.12.3220-3224.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Damen M., Zaaijer H. L., Cuypers H. T., Vrielink H., van der Poel C. L., Reesink H. W., Lelie P. N. Reliability of the third-generation recombinant immunoblot assay for hepatitis C virus. Transfusion. 1995 Sep;35(9):745–749. doi: 10.1046/j.1537-2995.1995.35996029158.x. [DOI] [PubMed] [Google Scholar]
- Donahue J. G., Muñoz A., Ness P. M., Brown D. E., Jr, Yawn D. H., McAllister H. A., Jr, Reitz B. A., Nelson K. E. The declining risk of post-transfusion hepatitis C virus infection. N Engl J Med. 1992 Aug 6;327(6):369–373. doi: 10.1056/NEJM199208063270601. [DOI] [PubMed] [Google Scholar]
- Dussaix E., Charnaux N., Laurent-Puig P., Chopineau S., Laurian Y., Buffet C. Analysis of sera indeterminate by Ortho-HCV RIBA-2 by using three confirmatory assays for anti-hepatitis C virus antibody. J Clin Microbiol. 1994 Sep;32(9):2071–2075. doi: 10.1128/jcm.32.9.2071-2075.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Farci P., Alter H. J., Wong D., Miller R. H., Shih J. W., Jett B., Purcell R. H. A long-term study of hepatitis C virus replication in non-A, non-B hepatitis. N Engl J Med. 1991 Jul 11;325(2):98–104. doi: 10.1056/NEJM199107113250205. [DOI] [PubMed] [Google Scholar]
- Feucht H. H., Zöllner B., Polywka S., Laufs R. Study on reliability of commercially available hepatitis C virus antibody tests. J Clin Microbiol. 1995 Mar;33(3):620–624. doi: 10.1128/jcm.33.3.620-624.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fong T. L., Charboneau F., Valinluck B., Govindarajan S. The stability of serum hepatitis C viral RNA in various handling and storage conditions. Arch Pathol Lab Med. 1993 Feb;117(2):150–151. [PubMed] [Google Scholar]
- Krajden M. Molecular detection of hepatitis C virus: impact of detection methodology on clinical and laboratory correlations. Crit Rev Clin Lab Sci. 1995;32(1):41–66. doi: 10.3109/10408369509084681. [DOI] [PubMed] [Google Scholar]
- Krajden M., Shankaran P., Bourke C., Lau W. Detection of cytomegalovirus in blood donors by PCR using the digene SHARP signal system assay: effects of sample preparation and detection methodology. J Clin Microbiol. 1996 Jan;34(1):29–33. doi: 10.1128/jcm.34.1.29-33.1996. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lee S. R., Wood C. L., Lane M. J., Francis B., Gust C., Higgs C. M., Nelles M. J., Polito A., DiNello R., Achord D. Increased detection of hepatitis C virus infection in commercial plasma donors by a third-generation screening assay. Transfusion. 1995 Oct;35(10):845–849. doi: 10.1046/j.1537-2995.1995.351096026366.x. [DOI] [PubMed] [Google Scholar]
- Lok A. S., Chien D., Choo Q. L., Chan T. M., Chiu E. K., Cheng I. K., Houghton M., Kuo G. Antibody response to core, envelope and nonstructural hepatitis C virus antigens: comparison of immunocompetent and immunosuppressed patients. Hepatology. 1993 Sep;18(3):497–502. [PubMed] [Google Scholar]
- Marcellin P., Martinot-Peignoux M., Elias A., Branger M., Courtois F., Level R., Erlinger S., Benhamou J. P. Hepatitis C virus (HCV) viremia in human immunodeficiency virus-seronegative and -seropositive patients with indeterminate HCV recombinant immunoblot assay. J Infect Dis. 1994 Aug;170(2):433–435. doi: 10.1093/infdis/170.2.433. [DOI] [PubMed] [Google Scholar]
- Marin M. G., Bresciani S., Puoti M., Rodella A., Gussago A., Ravaggi A., Pizzocolo G., Albertini A., Cariani E. Clinical significance of serum hepatitis C virus (HCV) RNA as marker of HCV infection. J Clin Microbiol. 1994 Dec;32(12):3008–3012. doi: 10.1128/jcm.32.12.3008-3012.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nolte F. S., Thurmond C., Fried M. W. Preclinical evaluation of AMPLICOR hepatitis C virus test for detection of hepatitis C virus RNA. J Clin Microbiol. 1995 Jul;33(7):1775–1778. doi: 10.1128/jcm.33.7.1775-1778.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pawlotsky J. M., Bastie A., Pellet C., Remire J., Darthuy F., Wolfe L., Sayada C., Duval J., Dhumeaux D. Significance of indeterminate third-generation hepatitis C virus recombinant immunoblot assay. J Clin Microbiol. 1996 Jan;34(1):80–83. doi: 10.1128/jcm.34.1.80-83.1996. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pawlotsky J. M., Fleury A., Choukroun V., Deforges L., Roudot-Thoraval F., Aumont P., Duval J., Dhumeaux D. Significance of highly positive c22-3 "indeterminate" second-generation hepatitis C virus (HCV) recombinant immunoblot assay (RIBA) and resolution by third-generation HCV RIBA. J Clin Microbiol. 1994 May;32(5):1357–1359. doi: 10.1128/jcm.32.5.1357-1359.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Prati D., Capelli C., Bosoni P., Mozzi F., Zanella A., Sirchia G. Determination of hepatitis C virus RNA in the serum by the Amplicor HCV PCR kit. Vox Sang. 1994;67(1):112–114. doi: 10.1111/j.1423-0410.1994.tb05054.x. [DOI] [PubMed] [Google Scholar]
- Quan C. M., Krajden M., Zhao J., Chan A. W. High-performance liquid chromatography to assess the effect of serum storage conditions on the detection of hepatitis C virus by the polymerase chain reaction. J Virol Methods. 1993 Aug;43(3):299–307. doi: 10.1016/0166-0934(93)90148-k. [DOI] [PubMed] [Google Scholar]
- Romeo J. M., Ulrich P. P., Busch M. P., Vyas G. N. Analysis of hepatitis C virus RNA prevalence and surrogate markers of infection among seropositive voluntary blood donors. Hepatology. 1993 Feb;17(2):188–195. [PubMed] [Google Scholar]
- Shev S., Foberg U., Fryden A., Hermodsson S., Lindh G., Lindholm A., Månsson A. S., von Sydow M., Weiland O., Widell A. 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. Vox Sang. 1993;65(1):32–37. doi: 10.1111/j.1423-0410.1993.tb04521.x. [DOI] [PubMed] [Google Scholar]
- Wang J. T., Wang T. H., Sheu J. C., Lin S. M., Lin J. T., Chen D. S. Effects of anticoagulants and storage of blood samples on efficacy of the polymerase chain reaction assay for hepatitis C virus. J Clin Microbiol. 1992 Mar;30(3):750–753. doi: 10.1128/jcm.30.3.750-753.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Watanabe M., Ohkoshi S., Tawaraya H., Miyajima T., Shimotohno K., Kamimura T., Asakura H. Hepatitis C viral markers in patients who received blood that was positive for hepatitis C virus core antibody, with genetic evidence of hepatitis C virus transmission. Transfusion. 1994 Feb;34(2):125–129. doi: 10.1046/j.1537-2995.1994.34294143939.x. [DOI] [PubMed] [Google Scholar]
- Wright T. L., Hsu H., Donegan E., Feinstone S., Greenberg H., Read A., Ascher N. L., Roberts J. P., Lake J. R. Hepatitis C virus not found in fulminant non-A, non-B hepatitis. Ann Intern Med. 1991 Jul 15;115(2):111–112. doi: 10.7326/0003-4819-115-2-111. [DOI] [PubMed] [Google Scholar]
- Young K. K., Archer J. J., Yokosuka O., Omata M., Resnick R. M. Detection of hepatitis C virus RNA by a combined reverse transcription PCR assay: comparison with nested amplification and antibody testing. J Clin Microbiol. 1995 Mar;33(3):654–657. doi: 10.1128/jcm.33.3.654-657.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Yun Z. B., Lindh G., Weiland O., Johansson B., Sönnerborg A. Detection of hepatitis C virus (HCV) RNA by PCR related to HCV antibodies in serum and liver histology in Swedish blood donors. J Med Virol. 1993 Jan;39(1):57–61. doi: 10.1002/jmv.1890390111. [DOI] [PubMed] [Google Scholar]
- Zaaijer H. L., Cuypers H. T., Reesink H. W., Winkel I. N., Gerken G., Lelie P. N. Reliability of polymerase chain reaction for detection of hepatitis C virus. Lancet. 1993 Mar 20;341(8847):722–724. doi: 10.1016/0140-6736(93)90488-3. [DOI] [PubMed] [Google Scholar]
- van der Poel C. L. Hepatitis C virus infection from blood and blood products. FEMS Microbiol Rev. 1994 Jul;14(3):241–246. doi: 10.1111/j.1574-6976.1994.tb00094.x. [DOI] [PubMed] [Google Scholar]
