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Anti-HCV seroconversion in multitransfused and immunocompromised patients. A long-term longitudinal study
C Cornu1, C Brusselmans, A Geubel
1Department of Virology, St. Luc University Clinics, UCL, Brussels, Belgium.
Vox Sanguinis
|January 1, 1994
Summary
Diagnosing posttransfusion hepatitis C can be delayed, as antibody detection often lags behind viral RNA presence. Early diagnosis requires Hepatitis C Virus (HCV) RNA testing, especially in immunocompromised patients.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Posttransfusion hepatitis C diagnosis relies on serological markers.
- Immunocompromised patients may exhibit delayed seroconversion.
- Hepatitis C Virus (HCV) infection can lead to chronic liver disease.
Purpose of the Study:
- To investigate the diagnostic timeline of posttransfusion hepatitis C in multitransfused, immunocompromised patients.
- To evaluate the utility of HCV RNA detection versus antibody testing for early diagnosis.
Main Methods:
- Analysis of long-term serum samples from 6 multitransfused, immunocompromised patients.
- Detection of HCV RNA using nested PCR targeting the 5' noncoding region (5'NCR).
- Assay of anti-HCV antibodies using third-generation tests.
Main Results:
- Significant delays were observed between elevated alanine aminotransferase and seroconversion, ranging from <5 to >38 months.
- Five out of six patients seroconverted after 14 months.
- Anti-NS3 and anti-NS4 antibodies often appeared first.
- HCV RNA was detectable prior to seroconversion.
Conclusions:
- Hepatitis C Virus (HCV) infection may be overlooked for extended periods in immunocompromised patients due to delayed seroconversion.
- Early diagnosis of posttransfusion hepatitis C necessitates the detection of HCV RNA.
- Nested PCR for HCV RNA is crucial for timely diagnosis in at-risk populations.