Use of confirmatory assays for diagnosis of hepatitis C viral infection in patients with hepatocellular carcinoma.
Serum samples from 87 patients with hepatocellular carcinoma (HCC) in the United States were tested for evidence of hepatitis C viral (HCV) infection using an immunoblot assay for antibodies to the hepatitis C virus and the polymerase chain reaction to detect HCV RNA. The findings with these assays were compared to those with a first generation enzyme-linked immunoassay (EIA). Antibody to HCV (anti-HCV) was detected in 14 patients (16%) by EIA; only eight of these were also positive by immunoblot and four had HCV RNA by reverse transcription polymerase chain reaction (RT-PCR). An additional four cases, negative by EIA, were found to be positive by immunoblot; two of these had HCV RNA in serum. Evidence of previous hepatitis B viral infection was noted in 15 patients (17%). Only two patients with antibody to hepatitis B core antigen also had anti-HCV by the immunoblot assay, suggesting that concomitant infection with the hepatitis B and C viruses was not common. Thus, HCV infection appears to play a less important role in the pathogenesis of HCC in the United States than in southern Europe and Japan and other etiologic factors should be sought in this population.
Mangia
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Liver Diseases Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland.
Vallari
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Di Bisceglie
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D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000150:complications*; D002648:Child; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016174:Hepacivirus / Q000276:immunology / Q000302:isolation & purification*; D006508:Hepatitis Antibodies / Q000097:blood; D006526:Hepatitis C / Q000150:complications / Q000382:microbiology*; D018937:Hepatitis C Antibodies; D006801:Humans; D015151:Immunoblotting; D008113:Liver Neoplasms / Q000097:blood / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction
D006508:Hepatitis Antibodies; D018937:Hepatitis C Antibodies