J Korean Soc Transplant.  1997 May;11(1):73-80.

Combined Interpretation of Pretransplant Anti-hepatitis C Virus(HCV) Antibody by 3rd Generation ELISA and HCV-RNA by Polymerase Chain Reaction (PCR) for the Prediction of Posttransplant Liver Dysfunction

Affiliations
  • 1Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
  • 2Department of Clinical Pathology, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Abstract

Currently accurate test for identification of HCV infection is not yet developed. We examined 1) the relationship between the result of anti-HCV by 3rd generation ELISA (ELISA/3) and of HCV-RNA by PCR from pre-transplant stored serum in 89 living donor renal transplant recipients and 2) the correlation between the result of each or combined tests and the development of post-transplant liver dysfunction (LDF). LDF was defined as the increment of serum transaminase over 100 I.U./ml in two consecutive tests. Patients with clinically or biopsy proven LDF by cyclosporine were excluded. Pre-transplant HCV infection rate assessed by ELISA/3 and PCR was 20.2 and 29.2% respectively. Patients with PCR (+) developed LDF frequently compared with negative partners (50 vs. 27%, p=0.0367). Significant disparity between ELISA/3 and PCR was present. In 71 ELISA/3 (-) patients, 16(22.5%) were positive for PCR. However 8 (44.4%) were negative for PCR in 18 ELISA/3 (+) patients. ELISA/3 (+) or PCR (+) patients developed LDF frequently rather than ELISA/3(-)/PCR(-) ones(50.0 vs. 23.6%, p=0.0106). We could explain these data with 5 possibilities; 1) end-stage renal failure patients had a blunt antibody production, 2) serum sample may be collected during the window period for antibody formation, 3) even ELISA/3 could not detect fine molecular response during the early HCV infection(false negative), 4) significant false positive or serum contamination in PCR test, and finally 5) self-clearing of HCV antigen may be present in the body. In conclusion, HCV detection by PCR method and antibody test by ELISA/3 must be complementary for the accurate evaluation of HCV infection during the recipient evaluation and posttransplantation follow-up period.

Keyword

Kidney transplantation; hepatitis C virus; ELISA/3; PCR; liver dysfunction

MeSH Terms

Antibody Formation
Biopsy
Cyclosporine
Enzyme-Linked Immunosorbent Assay*
Follow-Up Studies
Hepacivirus
Humans
Kidney Failure, Chronic
Kidney Transplantation
Liver Diseases*
Liver*
Living Donors
Polymerase Chain Reaction*
Transplantation
Cyclosporine
Full Text Links
  • JKSTN
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr