HCV‐Infection in Blood Donors: Association between Anti‐HCV Core IgM Antibodies and Serum HCV RNA

Abstract

Among 47 blood donors tested positive with HCV EIA 2.0 Abbott, 27 (57.4%) also reacted with four ¿third-generation' EIAs. The presence of anti-HCV antibodies was confirmed with 3 different immunoblot assays in 16 of 27 sera (34.0%) while 10 samples (21.3%) had indeterminate profile with antibodies usually directed against structural core antigen. Anti-HCV core IgM response was found in 12 of 47 sera (25.5%) and HCV viremia detected by the polymerase chain reaction (PCR) procedure was observed in 15 samples (31.9%). A comparative study of the different markers confirmed a good correlation between a strong antibody response in EIAs and immunoblot assays and the presence of HCV RNA in the serum; only 2 immunoblot indeterminate samples were PCR positive. An association was observed between IgM antibodies against "core' epitopes and HCV RNA carriage: all IgM-positive sera were found positive by PCR. However, the direct detection of viral genome remains the best method for identifying HCV carriers in the blood donor population.

Transfusion–Associated Hepatitis in a Tertiary Referral Hospital in India

“…Besides helping in the early detection of seroconversion, it has a higher sensitivity and specificity from the inclusion of NS5 antigen. Whereas anti–HCV EIA tests cannot differentiate between ‘infectious’ and ‘non–infectious’ persons, those tests have a higher sensitivity and hence would rarely be negative if the serum is HCV–RNA–positive [26]. …”

Anti‐HCV confirmatory testing of voluntary blood donors: comparison of the sensitivity of two immunoblot assays

“…Even after the introduction of universal donor screening for HCV RNA, there remains a need for anti‐HCV screening and access to confirmatory testing as some 30‐ to 40‐percent of HCV‐infected donors do not have detectable viremia 5,11,12 . The introduction of third‐generation anti‐HCV screening assays, incorporating the NS5 antigen, has been accompanied by the development of third‐generation immunoblot assays.…”

“…The introduction of third‐generation anti‐HCV screening assays, incorporating the NS5 antigen, has been accompanied by the development of third‐generation immunoblot assays. However, use of anti‐HCV immunoblots in confirmatory testing generates a number of donors with indeterminate results, the overwhelming majority of whom do not have detectable viremia 3,5,11‐14 . The significance of these indeterminate results in low‐risk populations can be difficult to determine, often creating problems for counseling donors regarding the relevance of these results to their current and future health status.…”