The clinical relevance of persistent recombinant immunoblot assay-indeterminate reactions: insights into the natural history of hepatitis C virus infection and implications for donor counseling.
The clinical relevance of persistent recombinant immunoblot assay-indeterminate reactions: insights into the natural history of hepatitis C virus infection and implications for donor counseling.
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DOI：
10.1111/j.1537-2995.2011.03524.x
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发表时间：
2012-09
期刊：
影响因子：
2.9
通讯作者：
Alter HJ
中科院分区：
文献类型：
--
作者：
Makuria AT;Raghuraman S;Burbelo PD;Cantilena CC;Allison RD;Gibble J;Rehermann B;Alter HJ
A solid phase recombinant-immunoblot-assay(RIBA) is often used to determine the specificity of antibody to hepatitis-C-virus(anti-HCV). The RIBA result is recorded as positive, negative or indeterminate. The interpretation of RIBA indeterminate reactivity and its significance to patients and blood donors are unclear. We attempted to address the clinical relevance of RIBA-indeterminate reactions in the context of the natural history of HCV infection in a prospectively followed cohort of anti-HCV positive blood donors. Donor demographics, HCV exposure history, humoral and cell-mediated immunity(CMI) to HCV were compared in 15 RIBA-indeterminates, 9 chronic-HCV-carriers and 8 spontaneously-recovered subjects. Serum samples were tested for the presence of anti-HCV by a liquid phase Luciferase-Immunoprecipitation-System(LIPS) assay. CMI was assessed by IFN-γ-ELISpot assay. In the quantitative LIPS assay, the sum of antibody responses to 6 HCV-antigens showed significant (p<0.001) step-wise diminution progressing downward from chronic-carriers to spontaneously-recovered to RIBA-indeterminates. CMI responses in RIBA-indeterminates were similar to spontaneously-recovered subjects, and greater than chronic-carriers and negative controls (p<0.008). A parenteral risk factor was identified in 13% of RIBA-indeterminates as compared with 89% of chronic-carriers and 87% of spontaneously-recovered subjects. On average, donors in the RIBA-indeterminate group were older than the other groups. The combined CMI and LIPS results suggest that persistent RIBA-indeterminate reactions generally represent waning anti-HCV responses in persons who have recovered from a remote HCV infection. In such cases, detectable antibody may ultimately disappear leaving no residual serologic evidence of prior HCV infection, as previously reported in a minority of long-term HCV-recovered subjects.
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影响因子：
13.5
作者：
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通讯作者：
SIMMONDS, P
影响因子：
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DONAHUE, JG;MUNOZ, A;NELSON, KE
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NELSON, KE