Ndimbie O K, Nedjar S, Kingsley L, Riddle P, Rinaldo C
Department of Pathology, University of Pittsburgh Medical Center, Pennsylvania.
Clin Diagn Lab Immunol. 1995 Mar;2(2):219-24. doi: 10.1128/cdli.2.2.219-224.1995.
Hepatitis C virus (HCV) infection may go undiagnosed and continue to present a source of community-acquired or transfusion-associated infection because of shortcomings in sensitivity, specificity, and reproducibility of serologic tests. This project was designed to longitudinally study persons who were HCV seropositive or were at risk for seroconversion to characterize the course of infection. Sequential serum samples obtained semiannually from 617 homosexual male volunteers were available for study from the Pittsburgh site of the Multicenter AIDS Cohort Study. Testing by anti-HCV enzyme immunoassay (EIA) was performed on baseline (1984 to 1985) and most-recent (censor date, August 1992) samples. Selected samples were also assayed for alanine aminotransferase and by recombinant immunoblot (RIBA II) and nested PCR. A total of 17 of 617 (2.8%) men were HCV seropositive at entry. Of the 600 seronegative men, 9 converted to HCV seropositive during the study interval. Parenteral sources of exposure could be identified in 6 of these 26 HCV-seropositive men. Four men were HCV seropositive at baseline and seronegative at their most recent visit. Of the 26 HCV-seropositive men, 12 were also seropositive for human immunodeficiency virus. EIA analysis of 298 longitudinal samples from the 26 men revealed three patterns of HCV seropositivity: persistent, intermittent, and rare. Nine men (35%) showed intermittent or rare seropositivity with periods of over 1 year between some seropositive samples. PCR was positive in 76% of the HCV EIA-positive and 84% of the RIBA-positive samples. Thus, a low but significant number of homosexual men were HCV seropositive with variable positivity over several years of follow-up. A portion of these men become HCV seronegative. Individuals who exhibit intermittent or rare seropositivity are a challenge to diagnosis.
丙型肝炎病毒（HCV）感染可能未被诊断出来，并由于血清学检测在敏感性、特异性和可重复性方面的不足，继续成为社区获得性感染或输血相关感染的一个来源。本项目旨在纵向研究HCV血清学阳性或有血清转化风险的人群，以描述感染过程。从多中心艾滋病队列研究的匹兹堡站点获得了617名同性恋男性志愿者每半年采集一次的连续血清样本用于研究。在基线（1984年至1985年）和最近（截止日期，1992年8月）的样本上进行了抗HCV酶免疫测定（EIA）检测。还对选定的样本进行了丙氨酸转氨酶检测，并采用重组免疫印迹法（RIBA II）和巢式聚合酶链反应（PCR）检测。617名男性中共有17名（2.8%）在入组时HCV血清学阳性。在600名血清学阴性的男性中，有9名在研究期间转为HCV血清学阳性。在这26名HCV血清学阳性男性中，有6名可以确定有肠道外暴露源。4名男性在基线时HCV血清学阳性，在最近一次随访时血清学阴性。在这26名HCV血清学阳性男性中，有12名同时也是人类免疫缺陷病毒血清学阳性。对这26名男性的298份纵向样本进行的EIA分析显示了HCV血清学阳性的三种模式：持续、间歇和罕见。9名男性（35%）表现出间歇或罕见的血清学阳性，在一些血清学阳性样本之间间隔超过1年。PCR在76%的HCV EIA阳性样本和84%的RIBA阳性样本中呈阳性。因此，在随访的几年中，有一小部分但数量显著的同性恋男性HCV血清学阳性，其阳性情况各不相同。这些男性中有一部分转为HCV血清学阴性。表现出间歇或罕见血清学阳性的个体对诊断构成挑战。
