Combined Interpretation of Pretransplant Anti-hepatitis C Virus(HCV) Antibody by 3rd Generation ELISA and HCV-RNA by Polymerase Chain Reaction (PCR) for the Prediction of Posttransplant Liver Dysfunction.
- Author:
Yu Seun KIM
1
;
Myoung Soo KIM
;
Joon Ho LEE
;
Hyon Suk KIM
;
Soon Il KIM
;
Jang Il MOON
;
So Hyang OH
;
Eun Mi LEE
;
Ho Yung LEE
;
Ki Il PARK
Author Information
1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Kidney transplantation;
hepatitis C virus;
ELISA/3;
PCR;
liver dysfunction
- MeSH:
Antibody Formation;
Biopsy;
Cyclosporine;
Enzyme-Linked Immunosorbent Assay*;
Follow-Up Studies;
Hepacivirus;
Humans;
Kidney Failure, Chronic;
Kidney Transplantation;
Liver Diseases*;
Liver*;
Living Donors;
Polymerase Chain Reaction*;
Transplantation
- From:The Journal of the Korean Society for Transplantation
1997;11(1):73-80
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Currently accurate test for identification of HCV infection is not yet developed. We examined 1) the relationship between the result of anti-HCV by 3rd generation ELISA (ELISA/3) and of HCV-RNA by PCR from pre-transplant stored serum in 89 living donor renal transplant recipients and 2) the correlation between the result of each or combined tests and the development of post-transplant liver dysfunction (LDF). LDF was defined as the increment of serum transaminase over 100 I.U./ml in two consecutive tests. Patients with clinically or biopsy proven LDF by cyclosporine were excluded. Pre-transplant HCV infection rate assessed by ELISA/3 and PCR was 20.2 and 29.2% respectively. Patients with PCR (+) developed LDF frequently compared with negative partners (50 vs. 27%, p=0.0367). Significant disparity between ELISA/3 and PCR was present. In 71 ELISA/3 (-) patients, 16(22.5%) were positive for PCR. However 8 (44.4%) were negative for PCR in 18 ELISA/3 (+) patients. ELISA/3 (+) or PCR (+) patients developed LDF frequently rather than ELISA/3(-)/PCR(-) ones(50.0 vs. 23.6%, p=0.0106). We could explain these data with 5 possibilities; 1) end-stage renal failure patients had a blunt antibody production, 2) serum sample may be collected during the window period for antibody formation, 3) even ELISA/3 could not detect fine molecular response during the early HCV infection(false negative), 4) significant false positive or serum contamination in PCR test, and finally 5) self-clearing of HCV antigen may be present in the body. In conclusion, HCV detection by PCR method and antibody test by ELISA/3 must be complementary for the accurate evaluation of HCV infection during the recipient evaluation and posttransplantation follow-up period.
