title: Lack of seronegative hepatitis C virus infections in patients with chronic renal failure.
abstract: BACKGROUND
  Recent reports have indicated that serologic testing for hepatitis C virus (HCV) in patients with chronic renal failure may be inadequate to detect infections in this patient population.
  
  
  METHODS
  We prospectively tested 258 patients with end-stage renal disease who were referred for evaluation for renal transplantation for anti-HCV using a second-generation enzyme immunoassay (EIA) and a second-generation qualitative reverse-transcriptase polymerase chain reaction (RT-PCR). We confirmed all positive EIAs with a third-generation recombinant immunoblot assay and genotyped RT-PCR-positive specimens.
  
  
  RESULTS
  We found that 22 patients (8.5%) had serological evidence of HCV infection. Nineteen (86%) of the antibody-positive patients were viremic (HCV RNA positive). All but 1 of the patients was infected with HCV genotype 1. None of the 233 HCV antibody-negative patients were shown to be viremic by RT-PCR.
  
  
  CONCLUSIONS
  No additional HCV cases were detected by screening all patients for HCV RNA by RT-PCR. However, RT-PCR is a valuable adjunct to serology in antibody-positive patients to distinguish resolved from active infections.
authors.affiliation: Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Violet A
authors.initials: VA
authors.lastname: Kelley
authors.forename: Jennifer
authors.initials: J
authors.lastname: Everett-Kitchens
authors.forename: Laura E
authors.initials: LE
authors.lastname: Brannon
authors.forename: Kathleen
authors.initials: K
authors.lastname: Connor
authors.forename: Enrique J
authors.initials: EJ
authors.lastname: Martinez
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Pearson
authors.forename: Frederick S
authors.initials: FS
authors.lastname: Nolte
mesh_terms: D005260:Female; D006526:Hepatitis C / Q000175:diagnosis*; D018937:Hepatitis C Antibodies / Q000097:blood*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000821:virology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D020133:Reverse Transcriptase Polymerase Chain Reaction
chemical_list: D018937:Hepatitis C Antibodies; D012367:RNA, Viral