Detection of total antibody against hepatitis A virus by an automated microparticle enzyme immunoassay.

A fully automated microparticle enzyme immunoassay, IMx HAVAB, was developed for the detection of antibody against hepatitis A virus (anti-HAV). In the IMx HAVAB assay which is run on the IMx instrument, 24 tests are completed in less than 45 minutes. IMx HAVAB sensitivity was 18-25 World Health Organization U/l and was more sensitive than the commercial RIA or EIA, HAVAB and HAVAB EIA, respectively. Specimens from blood donors, diagnostic and hospital patients and individuals with a variety of infectious and immune diseases were tested in parallel with IMx HAVAB and RIA or EIA. Overall agreement of 99.9% (2118/2121) was obtained. Prevalence of anti-HAV tested by IMx ranged from 12.3% in volunteer blood donors in St. Louis to 64.3% for hospital patients in New York City. Discordant specimens were reactive by IMx HAVAB but borderline negative by EIA or RIA, due to the better sensitivity of the IMx assay. IMx HAVAB detected both IgM and IgG subclasses of anti-HAV. Serial bleeds from six intravenous drug users with acute HAV infection were tested over 8 months for the presence of anti-HAV. At all time points, patients were strongly reactive for anti-HAV (titers greater than 1/1000). Anti-HAV titers rose during the first 20 weeks after presentation of symptoms and then declined with time.

Detection of antibodies to hepatitis C virus in U.S. blood donors.

An enzyme immunoassay (EIA) which utilizes a solid phase coated with a recombinant antigen (c100-3) derived from the hepatitis C virus (HCV) genome was evaluated for efficacy in the detection of antibodies to HCV (anti-HCV). The sensitivity of the antibody test was demonstrated by the detection of anti-HCV in a well-characterized panel of human specimens known to contain the infectious agent of non-A, non-B hepatitis. The specificity of the anti-HCV test was evaluated by testing 6,118 serum specimens from volunteer blood donors considered to be at low risk for exposure to HCV. The specificity of the anti-HCV EIA was demonstrated to be 99.56%, since 6,069 of 6,096 specimens from this low-risk group were nonreactive. A total of 49 (0.80%) of the 6,118 specimens were repeatedly reactive in the test, and 22 (46.81%) of the 47 specimens available for additional testing were confirmed as positive for antibodies to HCV c100-3. Among commercial plasma donors, 390 (10.49%) of 3,718 specimens were repeatedly reactive in the EIA. A total of 375 (97.40%) of the 385 specimens available for further testing were confirmed as positive. These limited data indicate that the prevalence of antibodies to HCV is 0.36% (22 confirmed positives among 6,118 specimens) among volunteer blood donors and 10.08% (375 confirmed positives among 3,718 specimens) among commercial plasma donors. The importance of confirmatory testing is discussed.