Low-positive anti-hepatitis C virus enzyme immunoassay results: An important predictor of low likelihood of hepatitis C infection
Low-positive anti-hepatitis C virus enzyme immunoassay results: An important predictor of low likelihood of hepatitis C infection
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DOI：
10.1373/49.3.479
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发表时间：
2003-03-01
影响因子：
9.3
通讯作者：
Seeff, LB
中科院分区：
文献类型：
--
作者：
Dufour, DR;Talastas, M;Seeff, LB
背景：丙型肝炎抗体检测（抗HCV酶免疫测定）通常被描述为阳性或阴性。几项研究，主要是在献血者，发现标本与低信号/截止NO比值通常是阴性时，用重组免疫印迹法（RIBA）或HCVRNA.Methods：我们回顾性审查了17 418个连续的抗-HCV结果从筛选程序的高风险退伍军人;抗-HCV阳性2986例（17.1%），S/C ≤ 3.7者490例（16.4%）。在1814抗-HCV阳性individual.Results：RIBA进行了263例低阳性抗-HCV，结果为阴性86%，不确定的12%，阳性2%。140例抗-HCV低阳性者中只有16例（11%）为HCVRNA阳性，而1435例抗-HCV高阳性者中HCVRNA阳性率为90%（P < 0.0001）。与抗-HCV高阳性者相比，抗-HCV低阳性者年龄较大（P < 0.0001），并且不太可能有HCV的危险因素（大多数P < 0.0001），多次丙氨酸氨基转移酶（ALT）活性值升高抗B核心抗原阳性率为19%比59%（P <0.0002）。在634个人与高抗-HCV滴度和多个ALT活性值增加，95%的HCV RNA阳性conclusions：S/C比是重要的，即使在高风险的个人，实验室应报告S/C比沿着与抗-HCV EIA结果，并进行补充RIBA测试在那些低阳性值，以避免报告假阳性结果。(C)2003年美国临床化学协会。
Background: Tests for hepatitis C antibodies (anti-HCV enzyme immunoassays) are usually described as positive or negative. Several studies, mainly in blood donors, have found that specimens with low signal/cutoff NO ratios are commonly negative when tested with a recombinant immunoblot assay (RIBA) or for HCV RNA.Methods: We retrospectively reviewed 17 418 consecutive anti-HCV results from a screening program for high-risk veterans; 2986 (17.1%) samples were anti-HCV-positive, and 490 (16.4%) had S/C ratios less than or equal to3.7 (low positive). Additional tests were performed in 1814 anti-HCV-positive individuals.Results: RIBA was performed in 263 patients with low-positive anti-HCV; results were negative in 86%, indeterminate in 12%, and positive in 2%. Only 16 of 140 individuals (11%) with low-positive anti-HCV values were HCV RNA-positive, whereas HCV RNA was positive in 90% of 1435 individuals with high-positive anti-HCV values (P < 0.0001). Compared with those with high-positive anti-HCV, individuals with low-positive anti-HCV values were older (P < 0.0001) and were less likely to have risk factors for HCV (P < 0.0001 for most), multiple increased alanine aminotransferase (ALT) activity values (30% vs 81%; P < 0.0001), or positive antihepatitis B core antigen (19% vs 59%; P < 0.0002). Among 634 individuals with high anti-HCV titers and multiple increased ALT activity values, 95% were HCV RNA positive.Conclusions: The S/C ratio is important even in high-risk individuals; laboratories should report the S/C ratio along with anti-HCV EIA results and perform supplemental RIBA testing in those with low-positive values to avoid reporting false-positive results. (C) 2003 American Association for Clinical Chemistry.