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

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 μl 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.