Related Experiment Videos
Prevalence of hepatitis-C virus infection in children with chronic post-transfusion hepatitis
E Puchhammer-Stöckl1, H Hofmann, F M Fink
1Institute of Virology, University of Vienna, Austria.
Insights
Diagnosing hepatitis C virus (HCV) infection in children with chronic hepatitis is challenging due to discrepancies in antibody tests. Combining antibody assays with HCV polymerase chain reaction (PCR) detects infection in about 90% of cases.
Area of Science:
- Hepatology
- Virology
- Pediatric Infectious Diseases
Background:
- Post-transfusion hepatitis in children presents diagnostic challenges.
- Accurate diagnosis of hepatitis C virus (HCV) infection is crucial for effective management.
Purpose of the Study:
- To evaluate the diagnostic accuracy of various serological assays and HCV polymerase chain reaction (PCR) for detecting HCV infection in children with chronic post-transfusion hepatitis.
- To assess the discrepancies between different diagnostic methods and their impact on diagnosis.
Main Methods:
- Utilized first- and second-generation HCV-antibody ELISA, confirmatory tests (recombinant immunoblot assay, line immunoassay), and HCV-PCR.
- Investigated HCV RNA detectability in antibody-positive and antibody-negative patients.
- Examined fluctuations in viremia by analyzing serial serum samples.
Main Results:
- Significant discrepancies (33%) were observed between different HCV antibody detection assays, highlighting diagnostic issues.
- HCV RNA was detected by PCR in only 69% of antibody-positive patients, suggesting fluctuating viremia.
- PCR identified HCV infection in 8 of 15 seronegative patients with chronic hepatitis, indicating limitations of serology alone.
- Combined antibody assays and PCR detected HCV in approximately 90% of patients.
- After investigating hepatitis B markers, only 6% of cases remained undiagnosed.
Conclusions:
- Serological diagnosis of HCV infection in children with chronic post-transfusion hepatitis is problematic due to assay discrepancies.
- HCV-PCR is essential for detecting infection, especially in seronegative individuals and when viremia fluctuates.
- A combination of antibody assays and HCV-PCR achieves high diagnostic sensitivity (approx. 90%) for chronic hepatitis in children.
- Further investigation, including hepatitis B markers, is necessary to diagnose remaining cases.
Abstract:
The prevalence of hepatitis-C virus (HCV) infection was investigated in a group of children with chronic post-transfusion hepatitis using a first- and second-generation HCV-antibody ELISA, 2 confirmatory tests (a second-generation recombinant immunoblot assay and a line immunoassay) as well as an HCV-polymerase chain reaction (PCR). In 33% of the children, clear discrepancies were observed between the 4 different HCV-antibody detection assays, indicating that the serological diagnosis of HCV infection is still problematic. HCV RNA was detectable by PCR in only 69% of the antibody positive patients, which may be due to a fluctuation of viraemia during the course of infection. Such a fluctuation was demonstrated in 6 patients from whom serum samples drawn at different times were investigated. In contrast, in 8 of the 15 seronegative patients, HCV infection was identified only by PCR, although the hepatitis had already persisted for more than 2 years. Antibody assays and PCR together detected HCV infection in about 90% of the patients with chronic hepatitis. When markers of hepatitis B infection were also investigated, only 6% of the cases remained undiagnosed.