Hepatitis C virus infections in transplant patients: serological and virological investigations.
Hepatitis C virus (HCV) is transmitted by organs of HCV antibody-positive donors to transplant recipients. This study investigated the serological and virological responses of 14 initially HCV antibody-negative transplant patients who received organs from four HCV antibody-positive donors (A-D) (before donor screening for HCV infection was introduced in 1991). Second generation HCV enzyme immunoassay (Abbott HCV EIA) was used to detect anti-HCV antibody. Recombinant immunoblot (RIBA-2; Chiron Corporation) and Wellcozyme Western blot (Wwb) assays were compared as confirmatory assays of positive EIA results. Reverse transcription (RT) followed by "nested" polymerase chain reaction (PCR) was performed to detect viral RNA. HCV RNA was only found in the sera of donors B and C, however, transplantation of organs from all donors resulted in infection of all recipients. HCV RNA was found in recipient sera within 30 days after transplant and remained detectable throughout the period of sampling. An anti-HCV antibody response was found in only 6 (of the 14) recipients and only after 300 days. Much longer periods passed before detection of HCV antibody in six recipients. For detection of HCV infection in transplant recipients it is essential that testing for HCV RNA by RT-PCR is carried out.
Maple
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Clinical Microbiology and Public Health Laboratory, Addenbrooke's Hospital, Cambridge, United Kingdom.
McKee
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Desselberger
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Wreghitt
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D000914:Antibodies, Viral / Q000097:blood; D001483:Base Sequence; D018562:Disease Transmission, Infectious; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification*; D006526:Hepatitis C / Q000097:blood / Q000276:immunology / Q000635:transmission* / Q000821:virology; D006801:Humans; D007118:Immunoassay / Q000379:methods; D008969:Molecular Sequence Data; D016377:Organ Transplantation; D016133:Polymerase Chain Reaction; D011183:Postoperative Complications / Q000097:blood / Q000276:immunology / Q000821:virology*; D012367:RNA, Viral / Q000097:blood; D014019:Tissue Donors
D000914:Antibodies, Viral; D012367:RNA, Viral