Andreu J, Abad M A, Sanchez-Quijano A, Torronteras R, Luque F, Garcia de las Heras J, Soto B, Pineda J A, Leal M, Lissen E
Department of Internal Medicine, Virgen del Rocio University Hospital, Seville, Spain.
J Intern Med. 1994 Jul;236(1):73-7. doi: 10.1111/j.1365-2796.1994.tb01122.x.
To investigate the concordance of anti-hepatitis C virus (anti-HCV) reactivity by a second-generation enzyme immunoassay (EIA-2) and by a four-antigen recombinant immunoblot assay (4-RIBA) in homosexual men, in comparison with that found in other sexually active groups and blood donors.
Prospective study.
Tertiary referral centre, Seville, Spain.
A total of 1203 subjects were studied. Eight hundred and three were sexually active individuals: 547 female prostitutes, 88 heterosexual men who had frequent sexual intercourse with prostitutes, and 168 homosexual men. All of them denied blood transfusion and parenteral drug use. In addition, 400 voluntary blood donors were selected at random.
All serum samples were screened for anti-HCV by EIA-2 and repeatedly reactive sera were tested by 4-RIBA. Homosexual men were also screened for anti-human immunodeficiency virus (anti-HIV), hepatitis B virus (HBV) markers and gammaglobulin concentration. Finally, serum samples from homosexual men reactive for anti-HCV by EIA-2 were analyzed for HCV-RNA by polymerase chain reaction (PCR).
Concordance between EIA-2 and 4-RIBA in female prostitutes (71.4%), clients of prostitutes (75.0%), and blood donors (83.3%) was significantly higher than in homosexual men (38.8%) (P < 0.04). In this collective the concordance between 4-RIBA and PCR was 85.7% for positive cases and 88.8% for negative ones, and EIA-2 ratios in reactive sera were significantly higher in 4-RIBA confirmed cases (P < 0.0001). No correlation between false positive EIA-2 results and presence of HIV infection, HBV markers or hypergammaglobulinaemia was found in homosexual men by univariate analysis.
There is a high level of non-specific anti-HCV reactivity by EIA-2 amongst homosexual men in comparison with that found in other sexually active groups and blood donors. The true prevalence of HCV infection amongst homosexual men could be even lower than previously described.
调查在男同性恋者中，第二代酶免疫测定法（EIA - 2）和四抗原重组免疫印迹法（4 - RIBA）检测抗丙型肝炎病毒（抗 - HCV）反应性的一致性，并与其他性活跃群体及献血者中的情况进行比较。
前瞻性研究。
西班牙塞维利亚的三级转诊中心。
共研究了1203名受试者。其中803名是性活跃个体：547名女性性工作者、88名与性工作者有频繁性行为的异性恋男性以及168名男同性恋者。他们均否认有输血及非肠道吸毒史。此外，随机选取了400名自愿献血者。
所有血清样本先用EIA - 2法筛查抗 - HCV，对反复呈反应性的血清再用4 - RIBA法检测。男同性恋者还接受了抗人类免疫缺陷病毒（抗 - HIV）、乙型肝炎病毒（HBV）标志物及γ球蛋白浓度的筛查。最后，对EIA - 2法检测抗 - HCV呈反应性的男同性恋者血清样本，采用聚合酶链反应（PCR）分析HCV - RNA。
女性性工作者（71.4%）、嫖客（75.0%）及献血者（83.3%）中，EIA - 2与4 - RIBA的一致性显著高于男同性恋者（38.8%）（P < 0.04）。在该群体中，4 - RIBA与PCR对阳性病例的一致性为85.7%，对阴性病例为88.8%，且在4 - RIBA确诊病例中，反应性血清的EIA - 2比值显著更高（P < 0.0001）。单因素分析未发现男同性恋者中EIA - 2假阳性结果与HIV感染、HBV标志物或高γ球蛋白血症之间存在相关性。
与其他性活跃群体及献血者相比，男同性恋者中EIA - 2检测到的非特异性抗 - HCV反应性水平较高。男同性恋者中HCV感染的实际患病率可能比之前描述的更低。
