Hepatitis C as the cause of chronic non-A, non-B hepatitis: high sensitivity of simultaneous measurement of core and non-structural antibodies.

First generation serologic tests (ELISA-1) for hepatitis C virus infection measure antibodies directed against a short non-structural segment of the virus (anti-c100-3). A major disadvantage of this test is that it lacks sensitivity in the identification of hepatitis C virus among patients at risk of infection. Thus, only 70-90% of chronic non-A, non-B cases are ELISA-1 positive. The present study set out to determine whether antibodies directed against the core region would be a more sensitive indicator of hepatitis C virus infection in patients with chronic non-A, non-B hepatitis. Sera were studied from 97 patients with raised serum alanine aminotransferase levels for more than 6 months in whom other causes of abnormal alanine aminotransferase were excluded. Using ELISA-1, 85 sera (87%) were anti-c100-3 positive. Sera were then tested for presence of antibody directed against Po, a core peptide of a Japanese strain of hepatitis C virus, using an ELISA method. Eighty-eight sera (91%) were anti-Po positive. Among the 12 anti-c100-3 negative patients, six were anti-Po positive. A second generation ELISA for anti-HCV (ELISA-2) incorporates a different antibody to the core region (c22-3) in addition to an expanded non-structural region, c200, which consists of c100-3 plus c33c. With these tests, all sera but one were positive, including 11 of 12 ELISA-1 negative and eight of nine anti-Po negative sera.(ABSTRACT TRUNCATED AT 250 WORDS)