Nephron 1992:61:365 366
M. Di Loretoa M. Ferrantea A. Panaroa P. Sorino b V. Coltela" D.A. Caringellab
Hepatitis C Virus Antibodies in Dialysis Pediatric Patients
a Serviziodi Immunoematologia e Trasfusione, e b Divisione di Nefrologia e Dialisi, Ospedale Pediátrico ‘Giovanni XXIII'. Bari, Italy
Abstract A new 4-antigen recombinant immunoblot assay (4-RIBA) for confirmation of hepatitis C virus (HCV) C-100 enzyme-linked immunosorbent assay (ELISA) reactivity was tested in serum samples of 11 pediatric patients on dialysis. Of 6 HCV C-100 ELISA-positive samples, all were 4-RIBA positive. The 2nd generation ELISA picked up 1 additional case confirmed by 4-RIBA. The 2nd generation tests increased the prevalence of HCV-positive cases.
Introduction A 2nd generation RIBA HCV assay was developed which utilises 4 recombinant antigens, inclusive of the 2 already present in the 1st generation RIBA HCV Test Sys tem. One of the two additional antigens is from the nonstructural NS3 region (C33c) and the other is an HCV-coreassociated antigen (C22) [1,2,3]. We have attempted to compare the results of the HCV C-100 ELISA test and RIBA I with ELISA II and RIBA II to verify the better sensitivity and specificity of the 2nd generation tests in pediatric population on dialysis.
Subjects and Methods In II pediatric patients on dialysis treated in the Nephrology and Dialysis Division o f ‘Giovanni X X III'Children’s Hospital of Bari, the antibody response to HCV was evaluated by both the Ortho HCV
C-100 ELISA Test System and the 2nd generation ELISA test, and by both the RIBA C-100 and 4-RIBA Test System. We considered also the mean S/Co, defined as the mean sample absorbance value (A492) divided by the calculated cutoff.
Results Of 6 HCV C-100 ELISA-positive samples (all with S/Co > 4), 4 were RIBA I positive, 2 undetermined cases were confirmed by 4-R1 BA. The 2nd generation ELISA picked up 2 additional cases missed by the 1st ELISA test: 1 with S/C o > 4 was confirmed by 4-RIBA (positive only for C33c and C22), the other one with a low S/C o (1.4) was not confirmed. Moreover, we noted that the prevalence of HCV infection increased with the duration of dialysis (p < 0.005) and the number of blood transfusions [4].
M. Di Loreto Scrvizio di Immunoematologia e Trasfusione Ospedulc Pediatrico 'Giovanni XX11I’ 1-70126 Bari (Italy)
© I992S. Karger AG. Basel 0028-2766/92/ 06I3-0365S2.75/0
Downloaded by: Stockholm University Library 130.237.165.40 - 1/18/2019 11:31:46 PM
Key Words Hepatitis C virus Dialysis pediatric patients 4-RIBA
Table 1. HCV tests in II pediatric patients on dialysis
Patient N°
Time on dialysis years
Transfusions
1 2 3 4 5 6 7 8 9 10 11
12.0 10.4 9.5 10.6 0.5 2.0 5.8 12.0 5.5 0.7 9.5
> > > >
N°
10 10 10 10 0 1 9 > 10 3 0 > 10
Ortho HCV Tests ELISA I S/Co
ELISA II S/Co
RIBA I
RIBA II
>4 >4 >4 >4 0.19 >4 0.23 >4 0.18 0.21 0.06
>4 >4 >4 >4 0.05 >4 0.09 >4 1.40 0.08 >4
pos pos pos pos IND (CIOO-3) pos IND (5-1-1) pos neg neg pos pos neg neg pos pos neg neg neg neg pos neg
S /C o = Mean sample A492/cutoff.
Discussion We noted that 4-RIBA is more specific to identify 100% of the undertermined patients by the C-100 RI BA test. Even
if we evaluated only few cases, we concluded that RIBA II should be a true confirmatory test for the ELISA assays which are used initially to screen patients for potential HCV infection.
References 3
Van der Poel C, Cuypers HTM, Reesink HW, Weiner AJ: Confirmation of hepatitiis C virus infection by new four-antigen recombinant im munoblot assay. Lancet 1991:337:317-319.
366
Di Loreto/Ferrante/Panaro/Sorino/ Collela/Caringella
4
Lindner G, Borgatti PP. Lusenti T, Franco V, Soliani F, Lindner L, Casali B. Rivasi P: Anticorpi anti virus epatite C in uremici in trattamento sostitutivo. 31st Congr Natl Soc Ital Nefrol, Siena. 1990.
Hepatitis C Virus Antibodies in Dialysis Pediatric Patients
Downloaded by: Stockholm University Library 130.237.165.40 - 1/18/2019 11:31:46 PM
1 Ebelig F, Naukkarinen R, Leikola J : Recombi nant immunoblot assay for hepatitis C virus antibody as predictor of infectivity. Lancet 1990: 335:982-983. 2 Skidmore S: Recombinant immunoblot assay for hepatitis C antibody. Lancet 1990:335:1346.
M. Di Loretoa M. Ferrantea A. Panaroa P. Sorino b V. Coltela" D.A. Caringellab
Hepatitis C Virus Antibodies in Dialysis Pediatric Patients
a Serviziodi Immunoematologia e Trasfusione, e b Divisione di Nefrologia e Dialisi, Ospedale Pediátrico ‘Giovanni XXIII'. Bari, Italy
Abstract A new 4-antigen recombinant immunoblot assay (4-RIBA) for confirmation of hepatitis C virus (HCV) C-100 enzyme-linked immunosorbent assay (ELISA) reactivity was tested in serum samples of 11 pediatric patients on dialysis. Of 6 HCV C-100 ELISA-positive samples, all were 4-RIBA positive. The 2nd generation ELISA picked up 1 additional case confirmed by 4-RIBA. The 2nd generation tests increased the prevalence of HCV-positive cases.
Introduction A 2nd generation RIBA HCV assay was developed which utilises 4 recombinant antigens, inclusive of the 2 already present in the 1st generation RIBA HCV Test Sys tem. One of the two additional antigens is from the nonstructural NS3 region (C33c) and the other is an HCV-coreassociated antigen (C22) [1,2,3]. We have attempted to compare the results of the HCV C-100 ELISA test and RIBA I with ELISA II and RIBA II to verify the better sensitivity and specificity of the 2nd generation tests in pediatric population on dialysis.
Subjects and Methods In II pediatric patients on dialysis treated in the Nephrology and Dialysis Division o f ‘Giovanni X X III'Children’s Hospital of Bari, the antibody response to HCV was evaluated by both the Ortho HCV
C-100 ELISA Test System and the 2nd generation ELISA test, and by both the RIBA C-100 and 4-RIBA Test System. We considered also the mean S/Co, defined as the mean sample absorbance value (A492) divided by the calculated cutoff.
Results Of 6 HCV C-100 ELISA-positive samples (all with S/Co > 4), 4 were RIBA I positive, 2 undetermined cases were confirmed by 4-R1 BA. The 2nd generation ELISA picked up 2 additional cases missed by the 1st ELISA test: 1 with S/C o > 4 was confirmed by 4-RIBA (positive only for C33c and C22), the other one with a low S/C o (1.4) was not confirmed. Moreover, we noted that the prevalence of HCV infection increased with the duration of dialysis (p < 0.005) and the number of blood transfusions [4].
M. Di Loreto Scrvizio di Immunoematologia e Trasfusione Ospedulc Pediatrico 'Giovanni XX11I’ 1-70126 Bari (Italy)
© I992S. Karger AG. Basel 0028-2766/92/ 06I3-0365S2.75/0
Downloaded by: Stockholm University Library 130.237.165.40 - 1/18/2019 11:31:46 PM
Key Words Hepatitis C virus Dialysis pediatric patients 4-RIBA
Table 1. HCV tests in II pediatric patients on dialysis
Patient N°
Time on dialysis years
Transfusions
1 2 3 4 5 6 7 8 9 10 11
12.0 10.4 9.5 10.6 0.5 2.0 5.8 12.0 5.5 0.7 9.5
> > > >
N°
10 10 10 10 0 1 9 > 10 3 0 > 10
Ortho HCV Tests ELISA I S/Co
ELISA II S/Co
RIBA I
RIBA II
>4 >4 >4 >4 0.19 >4 0.23 >4 0.18 0.21 0.06
>4 >4 >4 >4 0.05 >4 0.09 >4 1.40 0.08 >4
pos pos pos pos IND (CIOO-3) pos IND (5-1-1) pos neg neg pos pos neg neg pos pos neg neg neg neg pos neg
S /C o = Mean sample A492/cutoff.
Discussion We noted that 4-RIBA is more specific to identify 100% of the undertermined patients by the C-100 RI BA test. Even
if we evaluated only few cases, we concluded that RIBA II should be a true confirmatory test for the ELISA assays which are used initially to screen patients for potential HCV infection.
References 3
Van der Poel C, Cuypers HTM, Reesink HW, Weiner AJ: Confirmation of hepatitiis C virus infection by new four-antigen recombinant im munoblot assay. Lancet 1991:337:317-319.
366
Di Loreto/Ferrante/Panaro/Sorino/ Collela/Caringella
4
Lindner G, Borgatti PP. Lusenti T, Franco V, Soliani F, Lindner L, Casali B. Rivasi P: Anticorpi anti virus epatite C in uremici in trattamento sostitutivo. 31st Congr Natl Soc Ital Nefrol, Siena. 1990.
Hepatitis C Virus Antibodies in Dialysis Pediatric Patients
Downloaded by: Stockholm University Library 130.237.165.40 - 1/18/2019 11:31:46 PM
1 Ebelig F, Naukkarinen R, Leikola J : Recombi nant immunoblot assay for hepatitis C virus antibody as predictor of infectivity. Lancet 1990: 335:982-983. 2 Skidmore S: Recombinant immunoblot assay for hepatitis C antibody. Lancet 1990:335:1346.
