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The new automated Enzymun-Test anti-HBc Plus for the detection of antibodies to hepatitis B virus (HBV) core antigen (anti-HBc) after pretreatment with reducing agents dithiothreitol (25 degrees C; + DTT) or potassium bisulfite (37 degrees C; + MBS) was evaluated by testing 571 serum and plasma samples. The panel included dilution series of reference standards and samples from chronic carriers, one seroconversion panel, samples from patients in acute or chronic stage of the disease or resolved hepatitis B, preselected sera from blood donors that were initially reactive in an anti-HBc assay without pretreatment, potentially cross-reactive serum samples obtained from patients suffering from other diseases or with passed infections other than HBV, pregnant women and individuals with HBV vaccination. The IMx CORE(TM) (Abbott Diagnostics) served as reference assay. Discrepant samples were further investigated with two different commercial anti-HBc enzyme immunoassays, other HBV-specific serological markers and HBV DNA hybridization. The sensitivity of the Enzymun-Test Anti-HBc Plus (25 degrees + DTT, and 37 degrees C; + MBS) in comparison to the reference assay was 100%. The IMx CORE showed a twofold higher sensitivity than Enzymun-Test Anti-HBc Plus for anti-HBc detection in dilution series of serum samples from HBV carriers. The agreement in terms of specificity of the Enzymun-Test Anti-HBc Plus (25 degrees C; + DTT, and 37 degrees C; + MBS) and in comparison to IMx CORE was 97.4 and 96.4%, respectively. After resolution of discrepant results (3 samples were tested false negative with IMx CORE), the agreement in terms of specificity of the Enzymun-Test Anti-HBc Plus (25 degrees C; + DTT, and 37 degrees C; + MBS) in comparison to the combination of the comparative assays was 98.3 and 97.4%, respectively. In conclusion, the new automated Enzymun-Test Anti-HBc Plus with sample pretreatment with DTT (25 degrees C; + DTT) or MBS (37 degrees C; + MBS) permits a highly sensitive and specific detection of anti-HBc in diagnostic virology and blood donation testing.
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