Poor Performance of Hepatitis C Antibody Tests in Hospital Patients in Uganda
Loading...
Date
2010
Journal Title
Journal ISSN
Volume Title
Publisher
Journal of medical virology
Abstract
Most hepatitis C testing in Uganda is performed
using commercial rapid strip assays (RSA) to
detect antibodies to hepatitis C virus (anti-HCV),
rather than enzyme immunoassays (EIA). The
prevalence of hepatitis C antibodies in a Ugandan
hospital population was determined using
both methods to test their accuracy using nucleic
acid testing (NAT) as a reference. Sera from
380 consecutive hospitalized Ugandan patients
were tested for anti-HCV using anRSAin Uganda,
with subsequent automated third-generation EIA
testing in the United States, followed by NAT.
Recombinant immunoblot assays (RIBA) were
used as a supplementary test to detect anti-
HCV epitopes. Overall, anti-HCV was detected
in 48/380 (13%) by one or both antibody tests.
Anti-HCV was detected in 19 (5.0%) patients by
RSA and in 33 (8.7%) patients by EIA; only four
patients were anti-HCV positive by both methods.
Fourteen of the 48 anti-HCV positive patients had
detectable serum HCV RNA, 7 each by bDNA
assay or by PCR. RSA detected only 7 of 14 HCV
RNA positive sera. Of 29 RNA negative but
anti-HCV positive patients tested by RIBA, only
two were anti-HCV positive; 27 were anti-HCV
negative or indeterminate. Anti-HCV testing
by RSA and/or EIA was neither sensitive nor
specific for detection of ongoing HCV infection
in hospitalized Ugandan patients. Our findings
underscore the importance of confirmatory
nucleic acid testing, which, despite its increased
cost, appears essential to manage African
patients with HCV.
Description
Keywords
Rapid slide test, Enzyme immunoassay, Nucleic acid testing, Anti-HCV
Citation
Seremba, E., Ocama, P., Opio, C. K., Kagimu, M., Thomas, D. L., Yuan, H. J., ... & Lee, W. M. (2010). Poor performance of hepatitis C antibody tests in hospital patients in Uganda. Journal of medical virology, 82(8), 1371-1378. DOI 10.1002/jmv.21817