Inverse correlation between the titre of antibody to hepatitis C virus and the degree of hepatitis C viraemia

Serum immunoglobulin G antibodies to the GOR autoepitope are present in patients with occult hepatitis C virus (HCV) infection despite lack of HCV-specific antibodies

Antibody responses to the GOR autoepitope are frequently detected among anti-hepatitis C virus (anti-HCV)-positive patients with chronic hepatitis. Sera from 110 anti-HCV-negative patients with occult HCV infection, as diagnosed by detection of HCV RNA in hepatic tissue, were investigated for GOR antibody reactivity. A positive test for anti-GOR immunoglobulin G (IgG) was found for 22 (20%) of them. The frequency and titers of anti-GOR IgG were significantly lower than those in chronic hepatitis C patients (70/110, 63.6%; P < 0.001). Anti-GOR IgG was not detected in any of the 120 patients with HCV-unrelated liver disease. The anti-GOR IgG assay showed specificity and sensitivity values of 100% and 20%, respectively, among the sera from patients with occult HCV infection; the positive and negative predictive values were 100% and 44.3%, respectively. None of the clinical, laboratory, or histological characteristics of the patients with occult HCV infection were different according to GOR antibody status, except that the percentage of HCV RNA-positive hepatocytes was significantly greater (P = 0.042) in patients with occult HCV infection who tested positive for anti-GOR IgG. In conclusion, serum anti-GOR IgG is present in patients with occult HCV infection, despite a lack of detectable HCV-specific antibodies as determined by commercial tests. Testing for anti-GOR IgG in patients in whom HCV RNA is not detected in their sera may help with the identification of a subset of patients with occult HCV infection without the need to perform a liver biopsy.

Prevalence of hepatitis C virus antibodies in a clinic-based group of Italians from one geographic area

OBJECTIVE: To evaluate the prevalence of anti-HCV antibodies using subjects hospitalized in surgical departments and medical wards, and out-patients; secondly, to assess the evidence for developing chronic hepatitis in subjects positive for anti-HCV when compared with those with hepatitis B virus (HBV). METHODS: 21 888 serum samples from 18 380 subjects were investigated for anti-HCV antibodies using second and third generation immunoenzymatic assays. Some of these subjects were hospitalized patients and some were out-patients. RESULTS: THE STUDY SHOWED A 12.8&PERCNT; OVERALL ANTI-HCV PREVALENCE RATE WITH SIGNIFICANT DIFFERENCES BETWEEN OUT-PATIENTS (16.5&PERCNT;) OR SUBJECTS HOSPITALISED IN MEDICAL WARDS (16&PERCNT;) AND IN-PATIENTS IN SURGICAL DEPARTMENTS (7.7&PERCNT;). THE THIRD GROUP INCLUDED ASYMPTOMATIC SUBJECTS OVER TWENTY YEARS OLD WHOSE SERA WERE TESTED FOR ANTI-HCV ANTIBODIES AS PART OF ROUTINE PREOPERATION SCREENING AND NOT ON CLINICAL SUSPICION. HENCE, THIS GROUP, TOO, CAN BE CONSIDERED AS REPRESENTATIVE OF THE GENERAL POPULATION, AND THE PREVALENCE OF ANTI-HCV ANTIBODIES OBSERVED AMONG THEM AS THE PREVALENCE OF ANTI-HCV ANTIBODIES IN THE GENERAL POPULATION IN A NORTHERN ITALIAN AREA. THE DATA, FOLLOWING A CONFIRMATORY TEST (RIBA) ON POSITIVE SAMPLES, WERE ANALYSED FOR THEIR POSITIVITY TO DIFFERENT ANTIGENS (THE SIMULTANEOUS PRESENCE OF ANTIBODIES TO THE C-100, C-33 AND C-22 ANTIGENS), AS AN INDEX OF DEVELOPING CHRONIC VIRAL ACTIVITY. THIS WAS OBSERVED IN 63.4&PERCNT; OF POSITIVE PATIENTS FROM SURGICAL DEPARTMENTS: CONCLUSIONS: There is a large proportion of the asymptomatic population which could be chronically infected.

Evaluation of quantitative assay for antibody to hepatitis C virus core in patients treated with interferon

We titrated antibody to hepatitis C virus (anti-HCV) core of serum samples from 57 patients with chronic HCV infection, in an attempt to clarify the relationship between the level of HCV RNA and the outcome of interferon treatment. The patients studied were positive for both anti-HCV, by second-generation assay, and HCV RNA, by polymerase chain reaction, and had been treated with interferon for six months. Of the 57 patients, HCV RNA was eliminated in 16 by the time of discontinuation of interferon treatment (CR); in 19 this elimination was transient (PR) and for 22 elimination was nil (NR). The low HCV RNA level was accompanied by high titers of anti-HCV core while high HCV RNA levels were accompanied by low titers of anti-HCV core, with an inverse correlation (r = -0.322, P < 0.05). The mean titer of anti-HCV core before interferon treatment was 324 units in CR, 205 in PR, and 168 in NR, with a correlation ratio of 0.382 (P < 0.05). A decreased titer (more than 50%) was found in 68% of the CR. At the time of six-month follow-up, the anti-HCV core titers of CR had decreased by more than 50%, compared to pretreatment titers, while in PR and NR, there was an increase to above the pretreatment titers, without increases in HCV RNA levels or worsening of the hepatitis. In conclusion, quantitative assay for anti-HCV core is useful to assess the status of HCV replication.