HEPATITIS-C VIRUS-INFECTIONS IN TRANSPLANT PATIENTS - SEROLOGICAL ANDVIROLOGICAL INVESTIGATIONS

Hepatitis C virus (HCV) is transmitted by organs of HCV antibody-posit ive donors to transplant recipients. This study investigated the serol ogical and virological responses of 14 initially HCV antibody-negative transplant patients who received organs from four HCV antibody-positi ve donors (A-D) (before donor screening for HCV infection was introduc ed in 1991). Second generation HCV enzyme immunoassay (Abbott HCV EIA) was used to detect anti-HCV antibody. Recombinant immunoblot (RIBA-2; Chiron Corporation) and Wellcozyme Western blot (Wwb) assays were com pared as confirmatory assays of positive EIA results. Reverse transcri ption (RT) followed by ''nested'' polymerase chain reaction (PCR) was performed to detect viral RNA. HCV RNA was only found in the sera of d onors B and C, however, transplantation of organs from all donors resu lted in infection of all recipients. HCV RNA was found in recipient se ra within 30 days after transplant and remained detectable throughout the period of sampling. An anti-HCV antibody response was found in onl y 6 (of the 14) recipients and only after 300 days, Much longer period s passed before detection of HCV antibody in six recipients. For detec tion of HCV infection in transplant recipients it is essential that te sting for HCV RNA by RT-PCR is carried out. (C) 1994 Wiley-Liss, Inc.