Czaja A J, Taswell H F, Rakela J, Rabe D
Hepatobiliary Unit, Mayo Clinic, Rochester, Minnesota.
Gastroenterology. 1992 May;102(5):1675-9. doi: 10.1016/0016-5085(92)91729-n.
To determine the duration and specificity of antibodies to hepatitis C virus in hepatitis B surface antigen-negative chronic active hepatitis, sera from 19 patients seropositive by enzyme immunoassay were assessed by recombinant immunoblot assay. Only 12 of the 19 patients were reactive by immunoblot assay (63%). Patients nonreactive by immunoblot assay had lower signal-cutoff ratios by enzyme immunoassay (1.3 +/- 0.2 vs. 6.5 +/- 0.1; P less than 0.05), higher serum immunoglobulin G levels (4082 +/- 301 vs. 1760 +/- 143 mg/dL; P less than 0.05), and higher serum gamma globulin levels (3.3 +/- 0.5 vs. 2.04 +/- 0.1 g/dL; P less than 0.05) than reactive patients. Twelve of 14 patients with serial studies remained seropositive after 39 +/- 11 months of follow-up (range, 7-113 months). Only patients nonreactive by immunoblot assay became seronegative by enzyme immunoassay during corticosteroid therapy (2/3 vs. 0/6 patients). It is concluded that seropositivity by enzyme immunoassay may not be documented by immunoblot assay. Patients nonreactive by immunoblot assay have lower signal-cutoff ratios and higher gamma globulin levels than reactive patients, and their seropositivity may be nonspecific. Patients nonreactive by immunoblot assay may lose seropositivity by enzyme immunoassay during corticosteroid therapy.
为了确定乙肝表面抗原阴性的慢性活动性肝炎患者体内丙肝病毒抗体的持续时间和特异性，我们采用重组免疫印迹法对19例酶免疫法血清学阳性患者的血清进行了评估。19例患者中只有12例通过免疫印迹法检测呈阳性反应（63%）。免疫印迹法检测无反应的患者酶免疫法的信号-临界值比率较低（1.3±0.2 vs. 6.5±0.1；P<0.05），血清免疫球蛋白G水平较高（4082±301 vs. 1760±143 mg/dL；P<0.05），血清γ球蛋白水平也较高（3.3±0.5 vs. 2.04±0.1 g/dL；P<0.05）。14例进行系列研究的患者中，12例在39±11个月（范围7-113个月）的随访后仍为血清学阳性。只有免疫印迹法检测无反应的患者在皮质类固醇治疗期间酶免疫法检测变为血清学阴性（2/3 vs. 0/6例患者）。结论是酶免疫法血清学阳性可能无法通过免疫印迹法得到证实。免疫印迹法检测无反应的患者比有反应的患者信号-临界值比率更低，γ球蛋白水平更高，其血清学阳性可能不具有特异性。免疫印迹法检测无反应的患者在皮质类固醇治疗期间酶免疫法检测可能会失去血清学阳性。
