title: Clinical significance of discordant positive hepatitis C virus transcription-mediated amplification following end of treatment response.
abstract: BACKGROUND
  Polymerase chain reaction (PCR) assays are the standard for detecting hepatitis C virus viremia. The transcription-mediated amplification (TMA)-based assay is more sensitive.
  
  
  METHODS
  We retrospectively reviewed the charts of patients with a post-end of treatment (EOT) PCR-/TMA+ result to assess the clinical significance of a positive TMA result after a PCR negative EOT response or sustained viral response (SVR). Patients were divided into Group 1: PCR-/TMA+ after EOT response but during 24 week follow-up (n = 4); and Group 2: PCR-/TMA+ after SVR (n = 11).
  
  
  RESULTS
  All Group 1 patients achieved SVR. No Group 2 patients became PCR positive or had a rise in ALT. The TMA subsequently became negative in 6/7 patients with follow-up evaluation.
  
  
  CONCLUSIONS
  A discordant positive TMA post-EOT response or SVR did not seem to be clinically significant. This finding supports the possibility that patients with SVR have an acquired immune surveillance that prevents low-level viremia from progressing to clinical relapse.
authors.affiliation: Sarah C Upham Division of Gastroenterology and Hepatobiliary Diseases, New York Medical College, Munger Pavilion, Suite 206, Valhalla, NY 10595, USA.
authors.forename: Anisha
authors.initials: A
authors.lastname: Thadani
authors.forename: Jennifer
authors.initials: J
authors.lastname: Harley
authors.forename: Jonah
authors.initials: J
authors.lastname: Rubin
authors.forename: Edward
authors.initials: E
authors.lastname: Lebovics
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D018450:Disease Progression; D005500:Follow-Up Studies; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D021141:Nucleic Acid Amplification Techniques / Q000379:methods*; D012367:RNA, Viral / Q000097:blood*; D012008:Recurrence; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D012367:RNA, Viral