Couroucé A M, Le Marrec N, Girault A, Ducamp S, Simon N
National Institute of Blood Transfusion, Paris, France.
Transfusion. 1994 Sep;34(9):790-5. doi: 10.1046/j.1537-2995.1994.34994378281.x.
The results obtained in sequential specimens from recently infected subjects generally provide the best means of comparing the sensitivity of assays.
The sensitivity of second- and third-generation assays for antibody to hepatitis C virus (HCV) was compared on sequential specimens, generally collected at monthly intervals from 45 patients undergoing hemodialysis who seroconverted for HCV between 1980 and 1990.
Fifteen patients (33%) were positive earlier in the third-generation enzyme-linked immunosorbent assay (ELISA), with a mean difference of 17 days (range, 7-30) between the last negative and the first positive specimens. At the first rise in alanine aminotransferase, and at its peak, 63 and 91 percent of the patients, respectively, were anti-HCV positive in the third-generation ELISA. Third-generation recombinant immunoblot assay (RIBA) reacted at the same time as third-generation ELISA. Of the first specimens that were positive in second-generation ELISA, 44 percent reacted and 56 percent were indeterminate in third-generation RIBA, while 10 percent reacted, 72 percent were indeterminate, and 18 percent did not react in second-generation RIBA. From the beginning to the end of the follow-up, antibody to c33c was the most prevalent, followed in descending order by antibody to c22-3, antibody to c100-3, and antibody to NS5: 56, 54, 26, and 18 percent, respectively, at time 0, and 100, 86, 83, and 31 percent, respectively, 12 months later.
Third-generation assays (both ELISA and RIBA) were more sensitive than second-generation assays in the diagnosis of HCV infection, in that positive results were obtained earlier and a higher proportion of specimens were confirmed positive in RIBA testing.
从近期感染的受试者连续采集的样本所获得的结果，通常为比较检测方法的敏感性提供了最佳手段。
比较了第二代和第三代丙型肝炎病毒（HCV）抗体检测方法在连续样本上的敏感性，这些样本通常每月从45例在1980年至1990年间发生HCV血清转化的血液透析患者中采集。
15例患者（33%）在第三代酶联免疫吸附试验（ELISA）中更早出现阳性，最后一次阴性样本与首次阳性样本之间的平均差异为17天（范围7 - 30天）。在丙氨酸氨基转移酶首次升高时及其峰值时，分别有63%和91%的患者在第三代ELISA中抗HCV呈阳性。第三代重组免疫印迹试验（RIBA）与第三代ELISA同时出现反应。在第二代ELISA中首次呈阳性的样本中，44%在第三代RIBA中出现反应，56%结果不确定；而在第二代RIBA中，10%出现反应，72%结果不确定，18%无反应。从随访开始到结束，针对c33c的抗体最为普遍，其次依次为针对c22 - 3的抗体、针对c100 - 3的抗体和针对NS5的抗体：在0时刻分别为56%、54%、26%和18%，12个月后分别为100%、86%、83%和31%。
在HCV感染的诊断中，第三代检测方法（ELISA和RIBA）比第二代检测方法更敏感，因为能更早获得阳性结果，且在RIBA检测中有更高比例的样本被确认为阳性。
