LETTER
Correlation of Hepatitis C Virus Antibodies with Viremia
Heinz-Hubert Feucht, MD;
Bernhard Zollner, MD; and
Rainer Laufs, MD
15 April 1997 | Volume 126 Issue 8 | Pages 666-667
TO THE EDITOR:
Until now, it has been unclear how many patients with hepatitis C virus (HCV) antibodies have viremia and are thus infectious and how frequently spontaneous HCV elimination occurs [1-3]. In a retrospective study, we investigated serum samples of 2815 inpatients and outpatients with suspected liver disease from whom samples were obtained every 3 or 6 months for at least 2 years. Patients who received interferon therapy or were immunocompromised by other diseases were excluded. Serum samples were evaluated by HCV serologic testing and polymerase chain reaction (PCR) assay [4]. For serologic testing, HCV second-generation enzyme immunoassays were used; these results were confirmed by a four-antigen recombinant immunoblot assay established in our laboratory [5]. If the results of antibody testing and PCR were divergent, an additional sample was ordered and investigated a few weeks later.
Of 2815 patients with confirmed HCV antibodies, 2784 (98.9%) also had PCR results positive for HCV. From 31 patients (1.1%) who had antibodies to HCV but did not have positive PCR results, only 1 patient (0.04%) spontaneously lost detectable HCV viremia and HCV-specific antibodies 12 months later. This strongly indicates HCV elimination. The other 30 patients showed no disappearance of HCV antibodies for 2 years.
Our study clearly shows that the presence of confirmed HCV-specific antibodies correlates significantly (98.9%; P < 0.001) with HCV viremia and that spontaneous loss of viremia is a rare event in HCV infection. We also found that the elimination of HCV infection is not sufficiently predicted by the loss of detectable viremia in PCR but can be concluded from the disappearance of virus-specific antibodies.
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Author and Article Information
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Universitats-Krankenhaus Eppendorf, 20246 Hamburg, Germany
1. Young KK, Archer JJ, Yokosuka O, Omata M, Resnick RM. Detection of hepatitis C virus RNA by a combined reverse transcription PCR assay: comparison with nested amplification and antibody testing. J Clin Microbiol. 1995; 33:654-7.
2. Agnello V. Eradication of hepatitis C virus after interferon-
therapy [Letter]. Ann Intern Med. 1995; 122:474.
3. Meisel H, Reip A, Faltus B, Lu M, Porst H, Wiese M, et al. Transmission of hepatitis C virus to children and husbands by women infected with contaminated anti-D immunoglobulin. Lancet. 1995; 345:1209-11.
4. Feucht HH, Zollner B, Laufs R. Comparison of conventional autoradiography with a new DNA enzyme immunoassay for the detection of hepatitis C virus-polymerase chain reaction amplification products. J Virol Methods. 1995; 55:105-10.
5. Feucht HH, Zollner B, Polywka S, Laufs R. Study on reliability of commercially available hepatitis C virus antibody tests. J Clin Microbiol. 1995; 33:620-4.
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