Increased detection of antibody to hepatitis C virus in renal transplant patients by third-generation assays

To assess the sensitivity and specificity of third-generation assays for antibody to hepatitis C virus (anti-HCV), sera from 244 renal transplant patients (113 positive for anti-HCV enzyme-linked immunosorbent assay [ELISA]-2) were studied, Hepatitis C virus RNA was detected by a reverse-transcripted nested polymerase chain reaction, Antibody to HCV was detected by ELISA-3 in 108 (96%) ELISA-2-positive samples, Five (4%) ELISA-2-positive sera were negative by both ELISA-8 and polymerase chain reaction, In the anti-HCV-negative group, six (5%) additional cases were ELISA-8-positive; three of these were confirmed by recombinant immunoblot assay-3 (RIBA-3) and polymerase chain reaction, Recombinant immunoblot assay-3 was used to resolve 82 RIBA-2-indeterminate and three RIBA-2-negative sera, Using RIBA-3, 49 (60%) RIBA-a-indeterminate samples were positive, five (6%) ELISA-3-negative samples were negative, and 28 (34%) were remained indeterminate, Recombinant immunoblot assay-2-negative samples were indeterminate with RIBA-3, Hepatitis C virus RNA was detected in all RIBA-3-positive and 58% of the RIBA-3-indeterminate samples. Third-generation assays for anti-HCV are more sensitive and specific than second-generation assays in renal transplant patients. (C) 1996 by the National Foundation, Inc.