Sonmez E, Ozerol I H, Senol M, Kizilkaya N, Sahin K, Ozbilge H
Department of Infectious Diseases, Turgut Ozal Medical Center, Malatya, Turkey.
Isr J Med Sci. 1997 Nov;33(11):724-7.
There are limited data about false-positive reactions against hepatitis C virus (HCV) in syphilitic patients and false-positive reactions against syphilis in the patients with HCV infection. The aim of this study was to demonstrate the false-positivity of syphilis in patients with HCV infection, the false-positivity of anti-HCV in patients with syphilis and the validity of the serological tests in such patients. Fifty patients with positive anti-HCV, 21 patients with positive VDRL and 50 healthy subjects were studied. Syphilis serology was determined by the Venereal Disease Research Laboratory (VDRL) test and microhemagglutination for T. pallidum (MHA-TP) test. Hepatitis C serology was determined by a second generation ELISA (Ortho Diagnostics) test for HCV antibody, and anti-HCV positive patients were tested for HCV RNA by polymerase chain reaction (PCR). All assays were performed on all subjects. Not only the false-positive VDRL reaction in the patients with HCV infection but also false-positive anti-HCV tests in syphilitic patients have been observed. Four patients with syphilis had positive anti-HCV and negative HCV-RNA, whereas 10% (5 of 50) of patients with hepatitis C infection had positive VDRL and these patients were negative for MHA-TP test. The rates of false-positivity of VDRL and anti-HCV were higher than within the control group (p < 0.05). According to these data, positive anti-HCV in syphilitic patients and positive VDRL in chronic hepatitis C may be false-positive results with regard to the reaginic tests. Therefore, therapeutic measures should not be initiated without confirmation with a treponemal test or PCR. VDRL and HCV-ELISA tests may be interacted with IgM or IgG antibodies. This relationship should be investigated in further studies.
关于梅毒患者中丙型肝炎病毒（HCV）假阳性反应以及HCV感染患者中梅毒假阳性反应的数据有限。本研究的目的是证实HCV感染患者中梅毒的假阳性、梅毒患者中抗HCV的假阳性以及此类患者血清学检测的有效性。对50例抗HCV阳性患者、21例VDRL阳性患者和50名健康受试者进行了研究。梅毒血清学通过性病研究实验室（VDRL）试验和梅毒螺旋体微量血凝试验（MHA-TP）测定。丙型肝炎血清学通过第二代ELISA（Ortho诊断公司）检测HCV抗体来确定，抗HCV阳性患者通过聚合酶链反应（PCR）检测HCV RNA。对所有受试者进行了所有检测。不仅观察到HCV感染患者中VDRL假阳性反应，还观察到梅毒患者中抗HCV检测假阳性。4例梅毒患者抗HCV阳性但HCV-RNA阴性，而10%（50例中的5例）丙型肝炎感染患者VDRL阳性且这些患者MHA-TP试验阴性。VDRL和抗HCV的假阳性率高于对照组（p<0.05）。根据这些数据，梅毒患者中抗HCV阳性以及慢性丙型肝炎患者中VDRL阳性在反应素试验方面可能是假阳性结果。因此，在未经梅毒螺旋体试验或PCR确认之前不应开始治疗措施。VDRL和HCV-ELISA试验可能与IgM或IgG抗体相互作用。这种关系应在进一步研究中进行调查。
