1Abdel-Nasser MA, ²Mostafa MM, ³El-Deeb AM, ⁴Khafagy EE and ⁵Mahros KE.

Departments of ¹Microbiology and Immunology, ²Medical Biochemistry, ³Community Medicine and ⁵General Medicine, Al-Azhar University, and Department of ⁴General Medicine, Suez Canal University, Egypt.

This study was carried out on 1177 patients attending the Liver Disease, Renal Dialysis and Intensive Care Units of Al-Azhar and Suez Canal University hospitals. 850 blood donors were also included as a control group. Serum samples were collected from patients and blood donors. The morbidity rate of anti-HCV antibodies using enzyme linked-immunosorbent assay, second generation (ELISA 2^nd gen.) among patients and blood donors has been estimated. Patients with renal dialysis had a higher rate of HCV (58/155, 37.41 %), followed by chronic hepatitis (170/582, 29.21%). Intensive Care patients showed a lower rate (11/440, 2.50 %) followed by blood donors (15/850, 1.76 %). All HCV patients had high levels of alanine aminotransferase (ALT). HCV positive sera were further assayed with recombinant immunoblot assay (RIBA-2). All positive sera from the blood donors were still positive with RIBA-2. Almost all ELISA-positive sera from the intensive care group were also positive in this assay (10/11, 90.9 %). Most of the sera from chronic hepatitis and renal dialysis cases were also positive with RIBA-2 (49/58, 84.5 % and 147/170, 86.5 %, respectively). Indeterminate results have been detected in 8 (4.7 %) hepatitis and 6 (10.3%) renal dialysis patients. The sensitivity of ELISA was 87% for all groups and 100% for blood donors. These data indicate that normal population represented by blood donors have a low risk of HCV infection, whereas chronic hepatitis and renal dialysis patients have a high risk for transmission of infection by this virus. A positive correlation has been detected between confirmatory test like RIBA-2 and screening test like ELISA-2 and between them and ALT. ELISA-2 is a highly sensitive and convenient test which is easy to perform and when combined with RIBA-2 and ALT may be useful for diagnosis and monitoring of HCV infection and disease.