Application of commercial assays to detect IgG antibodies to hepatitis C virus in urine: A pilot study from autopsy cases

Abstract

Hepatitis C virus (HCV), the main cause of non-A, non-B hepatitis in the United States and possibly in the world, is believed to be transmitted primarily through parenteral exposure. Many screening and supplemental tests are available to detect antibodies to HCV in serum. The ability to use commercial assays to detect antibodies to HCV in urine was investigated in this study. A total of 229 serum/urine matched samples were collected sequentially from forensic autopsy cases examined at the Office of the Chief Medical Examiner, State of Maryland. Testing was performed using the Ortho, Innogenetics, and Abbott second generation HCV screening tests and the INNO-LIA HCV Ab supplemental assay. Sample volumes were increased for urine testing. Forty-six of 229 serum samples were positive by screening and confirmed by supplemental tests. The urine samples produced positive results on 44-45 of the same 46 by screening tests and all 46 positives by the supplemental test. There were no false positive samples using urine when compared with the serum pairs. The one false negative sample using urine was still nonreactive when the urine volume was increased to 200 microliters using the screening tests. Generally, five times the serum volume was required for the screening tests to be optimal for urine samples. The urine samples were stored under different conditions prior to testing to determine the influence on antibody stability in urine.

HCV antibodies in saliva and urine

“…The correlation between EIA and Western Blot in urine samples was poor, suggesting that most EIA-positive results reflected a nonspecific false positive reaction. These results differ from those of Zhang et al [1994] who reported an excellent correlation of anti-HCV detection between serum and urine. However, their study was carried out using serum and urine samples obtained from forensic autopsy cases and there is a possibility that urine samples were mixed with serum.…”

“…A correlation between serum antibodies and salivary or urinary antibodies has been reported in some viral infections, e.g., human immunodeficiency virus (HIV) [Archibald et al, 1986;Cao et al, 1989;Major et al, 1991;Crofts et al, 1991;Desai et al, 1991], hepatitis A virus (HAV) [Stuart et al, 1992;Parry et al, 1989], rubella [Saleh, 1991] and following immunization against polio virus [Zaman et al, 1991], rota virus [Ward et al, 1992;Friedman et al, 1993], and HAV [Hurni et al, 1993;Laufer et al, 1995]. As for HCV, oral fluid [Thieme et al, 1992;Sherman et al, 1994] and urine obtained from autopsy cases [Zhang et al, 1994] were suggested as alternative specimens for serum, for serodiagnosis of infection with this agent.…”

HCV antibodies in saliva and urine

“…A correlation between serum antibodies and salivary or urinary antibodies has been reported in some viral infections, e.g., human immunodeficiency virus (HIV) [Archibald et al, 1986;Cao et al, 1989;Major et al, 1991;Crofts et al, 1991;Desai et al, 1991], hepatitis A virus (HAV) [Stuart et al, 1992;Parry et al, 1989], rubella [Saleh, 1991] and following immunization against polio virus [Zaman et al, 1991], rota virus [Ward et al, 1992;Friedman et al, 1993], and HAV [Hurni et al, 1993;Laufer et al, 1995]. As for HCV, oral fluid [Thieme et al, 1992;Sherman et al, 1994] and urine obtained from autopsy cases [Zhang et al, 1994] were suggested as alternative specimens for serum, for serodiagnosis of infection with this agent.…”

Urinary immunoglobulins in viral diagnosis: An overview

“…The utility of urinary antibodies as a diagnostic tool has been investigated for certain viral diseases due to the inexpensive and non-invasive nature of sample collection 6 7 . During viral or bacterial infections, antibodies to immunoglobulins are excreted through urine, which have been found to be stable for considerable periods ( Table I ) 8 9 10 11 12 . The antibodies can be detected in urine using class-specific assays or Western blot 13 .…”