Use of an anti-hepatitis C virus (HCV) IgG avidity assay to identify recent HCV infection

There is no reliable and simple diagnostic marker available to diagnose recent hepatitis C virus (HCV) infection. It has been shown that the avidity of specific IgG antibody is low in primary viral infection and increases with time. We report the development of an anti-HCV avidity assay derived from a commercially available test. A panel of 117 sera was first examined for IgG avidity. It was composed of samples from patients with recent (group 1, n = 14), chronic (group 2, n = 70), and resolved (group 3, n = 33) HCV infections. Avidity index (AI) values observed in recently infected patients were significantly lower (12.0% +/- 9.2% [mean +/- standard deviation]) than those found in chronic carriers (83.1% +/- 15.2%). Using a threshold of 43.0%, this assay distinguished between groups 1 and 2 with very high sensitivity (98%) and specificity (100%). For group 3, a broader distribution of the AI values was observed (54.8% +/- 27.3%), suggesting that this index would not be useful in HCV RNA-negative patients. Blind validation of the test was carried out with a panel of 36 serum samples from 17 HCV seroconverters. The assay described here is a useful tool to distinguish recent from chronic infection in HCV-viremic patients.