Is hepatitis C serology reliable? Problems with clinical application
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1Department of Microbiology, Royal North Shore Hospital, St Leonards, NSW.
Objective:
To describe some inherent difficulties in the interpretation of anti-hepatitis C virus (HCV) antibody testing.
Clinical Features:
A 30-year-old carpark attendant sustained an accidental needlestick injury. The results of serological and biochemical investigations were suggestive of HCV infection but were not conclusive.
Intervention And Outcome:
Further testing was carried out on his stored sera in an attempt to establish a diagnosis. Two second generation enzyme-linked immunosorbent assay tests (Abbott and Ortho) gave differing results but were suggestive of seroconversion and subsequent seroreversion to HCV. Further testing with recombinant immunoblot assay and polymerase chain reaction did not resolve the issue.
Conclusion:
Our findings in this patient illustrate how the use of anti-HCV antibody tests in some clinical settings can result in confusion and misdiagnosis. These tests should be restricted to situations in which diagnostic usefulness has been established.