Enhanced detection of antibodies to hepatitis C virus by use of a third-generation recombinant immunoblot assay.

Fifty-seven sera with indeterminate results by the second generation RIBA (RIBA 2) for confirmation of hepatitis C virus (HCV) enzyme linked immunoassay (ELISA) reactivity were tested by the new third generation RIBA (RIBA 3). Thirty three (57.9%) displayed reactivity for at least one other band and were therefore classified as positive; two became negative and 22 (38%) remained indeterminate. The incidence of HCV viremia, as determined by the RNA polymerase chain reaction (PCR), was 75% for the latter sera. The data show that it is important to subject RIBA 3 indeterminate samples to PCR.