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A critical evaluation of hepatitis C testing of cadaveric corneal donors
K A Laycock1, L R Essary, S Delaney
1Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Purpose:
Enzyme immunoassays (EIAs) for hepatitis C virus (HCV) antibodies used to screen corneal donors are optimized for testing premortem sera. This study evaluated their efficiency when screening cadaveric sera.
Methods:
Abbott HCV EIA 2.0 was used to rescreen 101 cadaveric sera, 70 of which had tested positive and 31 negative by EIA 1.0. Matrix-HCV recombinant immunoblot assay was used as a reference standard. Antibody titers and reactivities were compared in premortem and cadaveric sera. Selected sera from confirmed seropositive donors were screened for virus by polymerase chain reaction (PCR).
Results:
HCV EIA 2.0 was 100% sensitive and 92.7% specific. EIA and Matrix-HCV gave similar end-point titers with pre- and postmortem sera. Viral RNA was detected in only three of 15 sera from seropositive donors.
Conclusions:
EIA 2.0 and Matrix-HCV efficiently screen cadaveric sera. However, HCV seropositivity does not necessarily indicate the presence of viral genomes in sera and tissues.