Background: Third-generation anti-hepatitis C virus (HCV) enzyme-linked immunosorbent assays (ELISA) are now implemented in most laboratories in Europe, but have not yet been fully implemented in the United States.
Study design and methods: Two ELISAs (Ortho 3.0 and Ortho 2.0, Ortho Diagnostics, Raritan, NJ) were compared by tests on various serum panels: A) blood donor samples (n = 530) that tested positive in first- or second-generation anti-HCV ELISA; B) samples from persons with chronic non-A, non-B hepatitis (n = 185); C) samples from multiply transfused patients (n = 79); D) samples from patients on hemodialysis (n = 473); and E) samples from Dutch random blood donors (n = 2153).
Results: In panels A, B, and C, 247 (100%) of 247 polymerase chain reaction (PCR)-positive and 278 (100%) of 278 second-generation recombinant immunoblot assay (RIBA-2)-positive specimens were detected by Ortho 2.0 and 3.0 (sensitivity, 100%). In the sera of panel D, used to represent a group of patients with a high risk for HCV, no additional positives were found by Ortho 3.0. In panel E, of 2153 blood donor samples, 2 (0.1%) were positive in Ortho 2.0 and 8 (0.4%) in Ortho 3.0. Two samples that were positive in both Ortho 2.0 and 3.0 were also positive in RIBA-2; one was positive on PCR. From the 6 remaining Ortho 3.0-positive (Ortho 2.0-negative) samples, 1 was positive in RIBA-2 (isolated anti-c100) and 3 were positive in third-generation RIBA (1/3 isolated anti-c100, 2/3 isolated NS5). All 6 samples were PCR negative. In first-time donors, no difference in specificity was found.
Conclusion: The sensitivity and specificity of the Ortho 3.0 ELISA are comparable to those of the Ortho 2.0 ELISA.