Digestive Diseases and Sciences

, Volume 41, Issue 1, pp 161–165 | Cite as

Chronic hepatitis C without anti-hepatitis C antibodies by second-generation assay

A clinicopathologic study and demonstration of the usefulness of a third-generation assay
  • Jia-Horng Kao
  • Ming-Yang Lai
  • Yue-Ting Hwang
  • Pei-Ming Yang
  • Pei-Jer Chen
  • Jin-Chuan Sheu
  • Teh-Hong Wang
  • Hey-Chi Hsu
  • Ding-Shinn Chen
Liver: Infectious, Inflammatory, and Metabolic Disorders

Abstract

To study the clinicopathologic features of hepatitis C viremic patients negative for hepatitis C antibodies (anti-HCV) by current second-generation assay, we categorized 139 consecutive histologically verified patients with chronic non-A, non-B hepatitis into three groups: 121 (87%) were positive for second-generation anti-HCV (group A); 10 (7%) were negative for second-generation anti-HCV but positive for HCV RNA (group B); and 8 (6%) were negative for both antibodies and viremia (group C). Six (60%) of group B patients could be further detected by a new third-generation assay, but none of group C patients was third-generation anti-HCV-positive. The demographic features, mean peak serum alanine aminotransferase levels, HCV genotype distribution, and histologic changes were comparable among the three groups. The study indicates that most patients with chronic hepatitis C in Taiwan could be identified by current second-generation assay, and viremic but antibody seronegative patients were clinicopathologically similar to the seropositives. Most patients of the latter group could be diagnosed by a third-generation assay, indicating the usefulness of this assay.

Key Words

chronic hepatitis C seronegative chronic hepatitis C chronic non-B, non-C hepatitis third-generation assay anti-HCV RT-PCR HCV genotype 

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References

  1. 1.
    Choo QL, Kuo G, Weiner AJ, Overby LR, Bradley DW, Houghton M: Isolation of a cDNA derived from a blood-borne non-A, non-B viral hepatitis genome. Science 244:359–362, 1989Google Scholar
  2. 2.
    Kuo G, Choo QL, Alter HJ, Gitnick GI, Redeker AG, Purcell RH, Miyamura T, Dienstag JL, Alter MJ, Stevens CE, Tegtmeier GE, Overby LR, Bradley DW, Houghton M: An assay for circulating antibodies to a major etiologic virus of human non-A, non-B hepatitis. Science 244:362–364, 1989Google Scholar
  3. 3.
    Houghton M, Weiner A, Han J, Kuo G, Choo QL: Molecular biology of the hepatitis C viruses: Implications for diagnosis, development and control of viral disease. Hepatology 14:381–388, 1991Google Scholar
  4. 4.
    Nakatsuji Y, Matsumoto A, Tanaka E, Ogata H, Kiyosawa K: Detection of chronic hepatitis C virus infection by four diagnostic systems: First-generation and second-generation enzyme-linked immunosorbent assay, second-generation recombinant immunoblot assay and nested polymerase chain reaction analysis. Hepatology 16:300–305, 1992Google Scholar
  5. 5.
    Kao JH, Tsai SL, Chen PJ, Yang PM, Sheu JC, Lai MY, Hsu HC, Sung JL, Wang TH, Chen DS: A clinicopathologic study of chronic non-A, non-B (type C) hepatitis in Taiwan: Comparison between posttransfusion and sporadic patients. J Hepatol 21:244–249, 1994Google Scholar
  6. 6.
    Alter HJ, Purcell RH, Shih JW, Melpolder JC, Houghton M, Choo QL, Kuo G: Detection of antibody to hepatitis C virus in prospectively followed transfusion recipients with acute and chronic non-A, non-B hepatitis. N Engl J Med 321:1494–1500, 1989Google Scholar
  7. 7.
    Chemello L, Cavalletto D, Pontisso P, Bortolotti F, Donada C, Donadon V, Frezza M, Casarin P, Alberti A: Patterns of antibodies to hepatitis C virus in patients with chronic non-A, non-B hepatitis and their relationship to viral replication and liver disease. Hepatology 17:179–182, 1993Google Scholar
  8. 8.
    Kao JH, Chen PJ, Yang PM, Lai MY, Sheu JC, Wang TH, Chen DS: Intrafamilial transmission of hepatitis C virus: The important role of infections between spouses. J Infect Dis 166:900–903, 1992Google Scholar
  9. 9.
    Sheu JC, Lee SH, Wang JT, Shih LN, Wang TH, Chen DS: Prevalence of anti-HCV and HCV viremia in hemodialysis patients in Taiwan. J Med Virol 37:108–112, 1992Google Scholar
  10. 10.
    Alter MJ, Margolis HS, Krawczynski K, Judson FN, Mares A, Alexander WJ, Hu PY, Miller JK, Gerber MA, Sampliner RE, Meeks EL, Beach MJ: The natural history of community-acquired hepatitis C in the United States. N Engl J Med 327:1899–1905, 1992Google Scholar
  11. 11.
    Bukh J, Wantzin P, Krogsgaard K, Knudsen F, Purcell RH, Miller RH, Copenhagen Dialysis HCV Study Group: 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. J Infect Dis 168:1343–1348, 1993Google Scholar
  12. 12.
    Chan TN, Lok ASF, Cheng IKP, Chan RT: Prevalence of hepatitis C virus infection in hemodialysis patients: A longitudinal study comparing the results of RNA and antibody assays. Hepatology 17:5–8, 1993Google Scholar
  13. 13.
    Di Bisceglie AM, Goodman ZD, Ishak KG, Hoofnagle JH, Melpolder JJ, Alter HJ: Long-term clinical and histopathological follow-up of chronic posttransfusion hepatitis. Hepatology 14:969–974, 1991Google Scholar
  14. 14.
    Sugitani M, Inchauspe G, Shindo M, Prince AM: Sensitivity of serological assays to identify blood donors with hepatitis C viraemia. Lancet 339:1018–1019, 1992Google Scholar
  15. 15.
    Marcellin P, Colin JF, Martinot-Peignoux M, Pham BN, Lefort V, Picault AB, Degott C, Erlinger S, Benhamou JP: Hepatitis C virus infection in anti-HIV positive and negative French homosexual men with chronic hepatitis: Comparison of second- and third-generation anti-HCV testing. Liver 13:319–322, 1993Google Scholar
  16. 16.
    International Group: Acute and chronic hepatitis revisited. Lancet 2:914–919, 1977Google Scholar
  17. 17.
    Okamoto H, Sugiyama Y, Okada S, Kurai K, Akahane Y, Sugai Y, Tanaka T, Sato K, Tsuda F, Miyakawa Y, Mayumi M: Typing hepatitis C virus by polymerase chain reaction with type-specific primers: Application to clinical surveys and tracing infectious sources. J Gen Virol 73:673–679, 1992Google Scholar
  18. 18.
    Kwok S, Higuchi R: Avoiding false positive with PCR. Nature 339:237–238, 1989Google Scholar
  19. 19.
    Lin HH, Kao JH, Leu JH, Young YC, Lee TY, Chen PJ, Chen DS: Comparison of three different immunoassays and PCR for the detection of hepatitis C virus infection in pregnant women in Taiwan. Vox Sang 65:117–121, 1993Google Scholar
  20. 20.
    Hosein B, Fang CT, Popovsky MA, Ye J, Zhang M, Wang CY: Improved serodiagnosis of hepatitis C virus infection with synthetic peptide antigen from capsid protein. Proc Natl Acad Sci USA 88:3647–3651, 1991Google Scholar
  21. 21.
    Weiner AJ, Kuo G, Bradley DW, Bonino F, Saracco G, Lee C, Rosenblatt J, Choo QL, Houghton M: Detection of hepatitis C viral sequences in non-A, non-B hepatitis. Lancet 335:1–3, 1990Google Scholar
  22. 22.
    Nagayama R, Tsuda F, Okamoto H, Wang Y, Mitsui T, Tanaka T, Miyakawa Y, Mayumi M: Genotype dependence of hepatitis C virus antibodies detectable by the first-generation enzyme-linked immunosorbent assay with C100-3 protein. J Clin Invest 92:1529–1533, 1993Google Scholar
  23. 23.
    Hosoda K, Omata M, Yokosuka O, Kato N, Ohto M: Nucleotide sequences of 5-1-1 of hepatitis C virus in patients with chronic liver disease. Gastroenterology 102:1039–1043, 1992Google Scholar
  24. 24.
    Tsai SL, Chen PJ, Hwang LH, Kao JH, Huang JH, Chang TH, Chen DS: Immune response to a hepatitis C virus nonstructural protein in chronic hepatitis C virus infection. J Hepatol 21:403–411, 1994Google Scholar
  25. 25.
    Muratori L, Giostra F, Cataleta M, Francesconi R, Ballardini G, Cassani F, Lenzi M, Bianchi FB: Testing for hepatitis C virus sequences in peripheral blood mononuclear cells of patients with chronic hepatitis C in the absence of serum hepatitis C virus RNA. Liver 14:124–128, 1994Google Scholar
  26. 26.
    Marcellin P, Martinot-Peignoux M, Gabriel F, Branger M, Degott C, Elias A, Xu LZ, Larzul D, Erlinger S, Benhamou JP: Chronic non-B, non-C hepatitis among blood donors assessed with HCV third generation tests and polymerase chain reaction. J Hepatol 19:167–170, 1993Google Scholar
  27. 27.
    Maclagan NF, Martin NH, Lunnon JB: The mechanism and interrelationship of the flocculation tests. J Clin Pathol 5:1–9, 1952Google Scholar
  28. 28.
    Lunel F, Musset L, Cacoub P, Frangeul L, Cresta P, Perrin M, Grippon P, Hoang C, Piette JC, Huraux JM, Opolon P: Cryoglobulinemia in chronic liver diseases: Role of hepatitis C virus and liver damage. Gastroenterology 106:1291–1300, 1994Google Scholar

Copyright information

© Plenum Publishing Corporation 1996

Authors and Affiliations

  • Jia-Horng Kao
    • 1
    • 2
    • 3
  • Ming-Yang Lai
    • 1
    • 2
    • 3
  • Yue-Ting Hwang
    • 1
    • 2
    • 3
  • Pei-Ming Yang
    • 1
    • 2
    • 3
  • Pei-Jer Chen
    • 1
    • 2
    • 3
  • Jin-Chuan Sheu
    • 1
    • 2
    • 3
  • Teh-Hong Wang
    • 1
    • 2
    • 3
  • Hey-Chi Hsu
    • 1
    • 2
    • 3
  • Ding-Shinn Chen
    • 1
    • 2
    • 3
  1. 1.Department of Internal Medicine, Graduate Institute of Clinical MedicineNational Taiwan University HospitalTaipeiTaiwan
  2. 2.Department of Pathology, National Taiwan University College of MedicineNational Taiwan University HospitalTaipeiTaiwan
  3. 3.Hepatitis Research CenterNational Taiwan University HospitalTaipeiTaiwan

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