title: Optimization, assessment, and proposed use of a direct nested reverse transcription-polymerase chain reaction protocol for the detection of hepatitis C virus.
abstract: OBJECTIVE
  To compare the performance of reverse transcription followed by the polymerase chain reaction (RT-PCR), without RNA purification, with the performance of classic protocols.
  
  
  METHODS
  Direct and classic techniques were used to test three groups of samples: six hepatitis C virus (HCV) seroconversion panels (n = 90), a HCV RNA reference panel (n = 26), and serial dilutions of four HCV-positive sera (n = 24). These methods were then applied sequentially through a clinical diagnostic algorithm to test 268 samples from high-risk patients.
  
  
  RESULTS
  For the three groups of samples, we found a 94% concordance between direct and purified RT-PCR methods. For the detection of HCV RNA in clinical samples, sensitivity was maximized and cost minimized using both protocols according to the proposed algorithm.
  
  
  CONCLUSIONS
  The direct PCR method is reliable, sensitive, and can result in time and cost savings. The suggested testing algorithm can enhance sensitivity and time savings for populations with a high prevalence of infection.
authors: University of Maryland School of Medicine, Department of Pathology, Baltimore, USA.
authors: M
authors: M
authors: Abdel-Hamid
authors: D C
authors: DC
authors: Edelman
authors: W E
authors: WE
authors: Highsmith
authors: N T
authors: NT
authors: Constantine
mesh_terms: D000465:Algorithms; D003362:Cost-Benefit Analysis; D016174:Hepacivirus / Q000302:isolation & purification*; D006801:Humans; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity