Fluctuating antibody response in a cohort of hepatitis C patients
Journal Title: Sultan Qaboos University Medical Journal - Year 2002, Vol 4, Issue 1
Abstract
Objective: This project was designed to longitudinally study persons who had antibodies to hepatitis C virus (HCV) to characterise the serologic course of infection. Methods: The subjects were 149 multitransfused patients (141 with thalassaemia major, 3 with thalassaemia intermedia, and 5 with sickle cell anaemia) who had been regularly followed up for 3 to 7 years. Sequential serum samples obtained semi-annually between January 1994 and January 2001 were tested, prospectively, by second or third generation HCV enzymelinked immunosorbent assay (ELISA), followed by confirmatory recombinant immunoblot assay (RIBA-2 or RIBA-3). Results: Of the 149 patients, 90 did not seroconvert to HCV, whereas 59 had detectable antibodies. On the basis of RIBA results in these 59 patients, 24 (41%) had persistent high antibody levels to structural and non structural HCV antigens, 11 (19%) had persistent low antibody levels, 17 (29%) showed fluctuating antibody levels, and in 5 patients (8%) there was a total or a partial disappearance of specific antibodies (seroreversion), mainly anti-core antibodies. Two patients (3%) had antibody responses that did not fit into any of these four categories. In patients with fluctuating antibody levels, there were periods ranging from 6 months to 2 years when anti-HCV antibodies could not be detected. Conclusion: This study shows that the antibody response to HCV in patients who receive frequent blood transfusions is very variable. Individuals who exhibit intermittent seropositivity are a challenge to diagnosis.
Authors and Affiliations
Said H S Al Dhahry| Departments of Microbiology and Immunology, Sultan Qaboos University Hospital, P O Box 38 , Al Khodh, Muscat 123, Sultanate of Oman, Shahina Daar| Department of Haematology, Sultan Qaboos University Hospital, P O Box 38 , Al Khodh, Muscat 123, Sultanate of Oman, Jameel C Nograles| Departments of Microbiology and Immunology, Sultan Qaboos University Hospital, P O Box 38 , Al Khodh, Muscat 123, Sultanate of Oman, Situsekara M W W B Rajapakse| Departments of Microbiology and Immunology, Sultan Qaboos University Hospital, P O Box 38 , Al Khodh, Muscat 123, Sultanate of Oman, Fadhila S S Al Toqi| Departments of Microbiology and Immunology, Sultan Qaboos University Hospital, P O Box 38 , Al Khodh, Muscat 123, Sultanate of Oman, Geraldine Z Kaminski| Departments of Microbiology and Immunology, Sultan Qaboos University Hospital, P O Box 38 , Al Khodh, Muscat 123, Sultanate of Oman
Keywords
Related Articles
- EP ID EP13661
- DOI -
- Views 347
- Downloads 17
Mycoplasma pneumoniae Pneumonia with Worsening Pleural Effusion Despite Treatment with Appropriate Antimicrobials: Case report
Mycoplasma pneumoniae is a common cause of community-acquired pneumonia. As M. pneumoniae pneumonia is usually a mild and self-limiting disease, complications such as pleural effusion occur only rarely. We report a 22-ye...
Acute Coronary Syndrome in Oman Results from the Gulf Registry of Acute Coronary Events
Acute coronary syndrome (ACS) is the most common cause of cardiovascular mortality and morbidity in Western countries. International guidelines for diagnosis and treatment have been developed based on randomised clinic...
Impact of Home-to-Centre Distance on Bone Marrow Transplantation Outcomes
Objectives: Haematopoietic stem cell transplantation (HSCT) in Oman started in 1994 at Sultan Qaboos University Hospital (SQUH), Muscat, Oman. Previous studies have suggested that longer driving time to the transplant ce...
The Use of Medicines in Oman Public Knowledge, Attitudes and Practices
Te objective of this study was to identify the common problems of medicine use in Oman in order to improve the appropriate use of medicines. Methods: A cross-sectional, pilot-tested questionnaire was administered to 6,...
Bilateral Absence of the Arcuate Artery on the Dorsum of the Foot With anomalous origin of dorsal metatarsal arteries
Bilateral absence of the arcuate artery was observed during routine dissection of the lower limbs of a 60-year-old male cadaver. Running distally on the dorsal aspect of both feet and opposite the tarso-metatarsal joint...