CHRONIC HEPATITIS-C WITHOUT ANTI-HEPATITIS-C ANTIBODIES BY 2ND-GENERATION ASSAY - A CLINICOPATHOLOGICAL STUDY AND DEMONSTRATION OF THE USEFULNESS OF A 3RD-GENERATION ASSAY

To study the clinicopathologic features of hepatitis C viremic patient s negative for hepatitis C antibodies (anti-HCV) by current second-gen eration assay, we categorized 139 consecutive histologically verified patients with chronic non-A, non-B hepatitis into three groups: 121 (8 7%) were positive for second-generation anti-HCV (group A); 10 (7%) we re negative for second-generation anti-HCV but positive for HCV RNA (g roup B); and 8 (6%) were negative for both antibodies and viremia (gro up C). Six (60%) of group B patients could be further detected by a ne w third-generation assay, but none of group C patients was third-gener ation anti-HCV-positive. The demographic features, mean peak serum ala nine aminotransferase levels, HCV genotype distribution, and histologi c changes were comparable among the three groups. The study indicates that most patients with chronic hepatitis C in Taiwan could be identif ied by current second-generation assay, and viremic but antibody seron egative patients were clinicopathologically similar to the seropositiv es. Most patients of the latter group could be diagnosed by a third-ge neration assay, indicating the usefulness of this assay.