al Meshari K, Alfurayh O, Al Ahdal M, Qunibi W, Kessie G, De Vol E
Department of Medicine, King Faisal Special Hospital and Research Centre, Riyadh, Saudi Arabia.
J Am Soc Nephrol. 1995 Nov;6(5):1439-44. doi: 10.1681/ASN.V651439.
The performance of two new hepatitis C virus antibody (anti-HCV) assays (a third-generation immunoglobulin (Ig)G recombinant immunoblot assay (RIBA 3.0) and hepatitis C virus core IgM (HCV IgM) in the prediction of hepatitis C viremia in hemodialysis patients was compared with that of a second-generation IgG recombinant immunoblot assay (RIBA 2.0). Forty-three patients on maintenance hemodialysis were studied. Aliquots of sera were tested prospectively for anti-HCV by RIBA 2.0, RIBA 3.0, and HCV IgM and for HCV RNA by polymerase chain reaction. Thirty-eight patients were HCV RNA positive. Among those, 7 (18%) were HCV IgM positive, 22 (58%) were RIBA 2.0 positive, and 29 (76%) were RIBA 3.0 positive. All but one viremic patients detected by HCV IgM were also detected by RIBA 2.0 and RIBA 3.0. All viremic patients detected by RIBA 2.0 were also detected by RIBA 3.0. RIBA 3.0 was more sensitive than RIBA 2.0 and HCV IgM in the detection of viremic patients (P = 0.0156 and < 0.0001, respectively). The positive predictive value for HCV IgM was 100% as compared with 96 and 97% for RIBA 2.0 and RIBA 3.0, respectively. The negative predictive value for RIBA 3.0 was 36% as compared with 24 and 14% for RIBA 2.0 and HCV IgM, respectively. At 6-months follow-up of the eight viremic patients without a detectable IgM or IgG anti-HCV response, all patients remained RIBA 2.0 nonreactive, one became RIBA 3.0 indeterminate, and one became HCV IgM positive. These data suggest that HCV IgM has poor sensitivity in the detection of hepatitis C viremia and RIBA 3.0 improves the sensitivity of IgG anti-HCV assays in the early detection of hepatitis C viremia in hemodialysis patients.
将两种新型丙型肝炎病毒抗体（抗-HCV）检测方法（第三代免疫球蛋白（Ig）G重组免疫印迹法（RIBA 3.0）和丙型肝炎病毒核心IgM（HCV IgM））在预测血液透析患者丙型肝炎病毒血症方面的性能，与第二代IgG重组免疫印迹法（RIBA 2.0）进行了比较。对43例维持性血液透析患者进行了研究。前瞻性地用RIBA 2.0、RIBA 3.0和HCV IgM检测血清样本中的抗-HCV，并通过聚合酶链反应检测HCV RNA。38例患者HCV RNA呈阳性。其中，7例（18%）HCV IgM呈阳性，22例（58%）RIBA 2.0呈阳性，29例（76%）RIBA 3.0呈阳性。除1例病毒血症患者外，所有被HCV IgM检测到的病毒血症患者也被RIBA 2.0和RIBA 3.0检测到。所有被RIBA 2.0检测到的病毒血症患者也被RIBA 3.0检测到。在检测病毒血症患者方面，RIBA 3.0比RIBA 2.0和HCV IgM更敏感（P分别为0.0156和<0.0001）。HCV IgM的阳性预测值为100%，而RIBA 2.0和RIBA 3.0分别为96%和97%。RIBA 3.0的阴性预测值为36%，而RIBA 2.0和HCV IgM分别为24%和14%。在对8例病毒血症患者进行6个月的随访中，这些患者均未检测到IgM或IgG抗-HCV反应，所有患者RIBA 2.0仍无反应，1例RIBA 3.0结果不确定，1例HCV IgM呈阳性。这些数据表明，HCV IgM在检测丙型肝炎病毒血症方面敏感性较差，而RIBA 3.0提高了IgG抗-HCV检测方法在早期检测血液透析患者丙型肝炎病毒血症方面的敏感性。
