ANTIBODIES TO HEPATITIS-C VIRUS BY 2ND-GENERATION TEST IN HEMODIALYZED PATIENTS

To assess the prevalence and the incidence of hepatitis C virus (HCV) in a dialysis unit, we prospectively tested for anti-HCV in chronic he modialysis patients and staff members since January 1989, using a firs t generation assay. Incidence was nil in staff and low in patients (3. 7% in 89, 1% in 90), and prevalence was 30% in patients. In January 19 91 blood samples from 115 patients were tested by first (EL1) and seco nd generation (EL2) ELISA (Ortho Diagnostic System). Positive subjects were tested by a RIBA-2 confirmation test. Fifty-three patients were negative by all tests. Positive tests were observed in 62 patients (54 %) including 36 positive in EL1 and EL2, and 26 only by EL2. All posit ive patients were reactive by RIBA-2 but nine were classified undeterm ined (only one positive band). In five patients reactivity of antibodi es to 5-1-1 and C-100-3 gradually declined during the study. Second ge neration tests gave a better correlation with time on dialysis and blo od transfusion. We conclude that second generation tests for HCV are m ore acurate for estimating true prevalence of HCV infection in hemodia lysis units.