Antibody Responses to Hepatitis C Virus by Second‐Generation Immunoassays in a Cohort of Patients with Bleeding Disorders

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Abstract
The antibody responses and the prevalence patterns of antibodies to hepatitis C virus (anti‐HCV) in a cohort of patients (n = 210) with bleeding disorders were studied using a first‐generation and a second‐generation enzyme immunoassays (EIA‐1, EIA‐2) as well as a second‐generation recombinant immunoblot assay (RIBA‐2). The anti‐HCV prevalence as determined by EIA‐1 and EIA‐2 was 183/210 (87.1%) and 197/210 (93.8%), respectively (p = 0.0026). None of the 17 EIA‐2(+)/EIA‐1(‐) samples was scored nonreactive by RIBA‐2. At follow‐up, samples of 123 patients were tested. Twenty‐nine out of 111 patients reactive by EIA‐1 seroreverted according to EIA‐1 while the sero‐reversion rate with EIA‐2 was 0 out of the 121 (p2.0) were observed in 94/150 (62.7%) and 45/47 (95.7%) of the anti‐HIV‐1‐positive and ‐negative patients, respectively (p = 10‐5). The decreasing anti‐HCV reactivity among anti‐HIV‐1‐positive individuals was mainly due to diminishing c33c reactivity. Seroconversion to anti‐HCV was observed in 3/7 (42.9%) cases with acute icteric non‐A, non‐B hepatitis by both EIA‐1 and EIA‐2, while the remaining 4 cases had detectable levels of anti‐HCV 1–18 months before the acute episode.