Comparison of the enzyme-linked immunosorbant assay III, recombinant immunoblot third generation assay, and polymerase chain reaction method in the detection of hepatitis C virus infection in haemodialysis patients.

Hepatitis C virus (HCV) serotyping assays have evolved from simple antibody screening tests to complex RNA-based qualitative and quantitative methods. The objective of this study was to compare the HCV screening results from 161 patients in long-term maintenance haemodialysis (HD) as assessed by the recently developed Enzyme Linked ImmunosorbantAssay III (ELISA III), confirmed by the Recombinant Immunoblot 3rd generation assay (RIBA 3rd) and determined by the qualitative HCV reverse transcription polymerase chain reaction (RT-PCR) method. One hundred sixty-one HD patients were tested for the presence of anti-HCV antibodies by the ELISA III and confirmed by the RIBA 3rd. HCV RNA was determined by an HCV RT-PCR method. All reported results that were designated as discrepant, anti-HCV (+) and/or HCV RNA (+) were further investigated by means of a quantitative HCV RT-PCR assay. Reported results obtained from ELISA III and qualitative RT-PCR assays were HCV positive for 16/161 patients (9,93%) and these were designated as anti-HCV (+)/HCV RNA (+). Subsequently, these 16 anti-HCV positive/161 HD patients were confirmed by the RIBA 3rd. Three individuals anti-HCV (-)/RIBA (+)/HCV RNA (-)], the viral load that was reported from the quantitative RT-PCR was less than the assay detection level (< 2,000 viral copies/ml). In view of previous observations, our findings suggest that ELISA III remains still a highly reliable and valuable assay. However, despite the cost, the combination of both ELISA III and qualitative RT-PCR allows a definitive classification on HCV diagnosis.