Petitjean Lecherbonnier J, Gouarin S, Dina J, Vabret A, Freymuth F
Laboratoire de Virologie Humaine et Moléculaire, Hôpital Universitaire, Avenue Georges-Clémenceau, 14033, Caen, France.
Pathol Biol (Paris). 2007 Dec;55(10):512-20. doi: 10.1016/j.patbio.2007.09.001. Epub 2007 Oct 23.
In spite of improvement of the third-generation enzyme immunoassay (EIA) for screening HCV antibodies, some non-specific reactions persist. With commercialisation of a new chemiluminescence microparticle immunoassay (CMIA), we assessed the specificity of 2 assays providing by Abbott Diagnostics: CMIA-ARCHITECT anti-HCV and MEIA-AxSYM HCV 3.0 for qualitative detection of HCV antibodies in serum sample of patients collected in CHU of Caen.
Anti-HCV results of 9753 serum samples tested by MEIA-AxSYM V.3 (2004), 6135 tested by CMIA-ARCHITECT1 (April to December 2005) and 5598 tested by CMIA-ARCHITECT2 (February to August 2006) were retrospectively analysed. Prevalences were calculated according to S/C ratio. The serum samples with an average S/C ratio from 1 to 2 for CMIA-ARCHITECT2 were confirmed with an immunoblot assay (Chiron RIBA HCV 3.0 SIA).
The CMIA-ARCHITECT assays showed a strong discrimination between negative and positive samples. We observed a tiny distribution of negative results. The percentage of "low positive" was respectively 1.26% for the MEIA-AxSYM, 0.68% for the CMIA-ARCHITECT1 and 0.36% for the CMIA-ARCHITECT2. Thirty-three of 54 (61%) samples yielding S/C ratio between 1 and 2 in the initial screening analysis with the CMIA-ARCHITECT1 were tested negative with CMIA-ARCHITECT2. Among the 21 remaining, 62% of RIBA results were interpretable.
CMIA-ARCHITECT assays improve the anti-HCV screening with a decrease of low-positive reactivity. However, low-positive results persist for which it is difficult to distinguish false-positive from low titer of antibodies. Supplemental assays such as immunoblot can be recommended in particularly context to more improve specificity and HCV-RNA detection should exclude a seroconversion.
尽管第三代酶免疫测定法(EIA)用于丙型肝炎病毒(HCV)抗体筛查已有改进,但仍存在一些非特异性反应。随着新型化学发光微粒子免疫测定法(CMIA)的商业化,我们评估了雅培诊断公司提供的两种检测方法的特异性:CMIA-ARCHITECT抗-HCV和MEIA-AxSYM HCV 3.0,用于定性检测在卡昂大学医院收集的患者血清样本中的HCV抗体。
回顾性分析了用MEIA-AxSYM V.3(2004年)检测的9753份血清样本、用CMIA-ARCHITECT1(2005年4月至12月)检测的6135份血清样本以及用CMIA-ARCHITECT2(2006年2月至8月)检测的5598份血清样本的抗-HCV结果。根据S/C比值计算患病率。对CMIA-ARCHITECT2平均S/C比值为1至2的血清样本用免疫印迹法(Chiron RIBA HCV 3.0 SIA)进行确认。
CMIA-ARCHITECT检测方法在阴性和阳性样本之间显示出很强的区分能力。我们观察到阴性结果分布极少。MEIA-AxSYM的“低阳性”百分比分别为1.26%,CMIA-ARCHITECT1为0.68%,CMIA-ARCHITECT2为0.36%。在最初用CMIA-ARCHITECT1进行筛查分析时,S/C比值在1至2之间的54份样本中有33份(61%)用CMIA-ARCHITECT2检测为阴性。在其余的21份样本中,62%的免疫印迹结果可解读。
CMIA-ARCHITECT检测方法通过降低低阳性反应性改进了抗-HCV筛查。然而,低阳性结果仍然存在,很难区分假阳性和低滴度抗体。在特定情况下,可推荐使用免疫印迹等补充检测方法以进一步提高特异性,并且HCV-RNA检测应排除血清转化情况。