Hofgärtner W T, Kant J A, Weck K E
Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania 15213-2500, USA.
J Clin Microbiol. 2000 Feb;38(2):888-91. doi: 10.1128/JCM.38.2.888-891.2000.
A long-term assessment of quantitative hepatitis C virus (HCV) testing was performed at the University of Pittsburgh Medical Center. The Quantiplex HCV RNA 2.0 branched-chain DNA (bDNA) assay (Bayer Diagnostics) for hepatitis C viral load determination was used to test 3,471 specimens. bDNA-negative samples were also tested by an in-house qualitative reverse transcriptase (RT)-PCR assay with a measured sensitivity of fewer than 100 HCV genome equivalents per milliliter. Of 1,239 bDNA-negative specimens, 74.1% were negative and 25.9% were positive by RT-PCR, indicating the presence of viremia in a significant proportion of bDNA-negative samples. We discuss the medical and economic implications of these results and propose two alternatives for clinical laboratories to consider in approaching quantitative HCV testing. For laboratories able to perform a sensitive RT-PCR assay for </=40% of the bDNA test cost, prescreening bDNA requests by RT-PCR may be the most cost-effective approach.
匹兹堡大学医学中心对丙型肝炎病毒（HCV）定量检测进行了长期评估。采用用于测定丙型肝炎病毒载量的Quantiplex HCV RNA 2.0分支DNA（bDNA）检测法（拜耳诊断公司）对3471份标本进行检测。bDNA阴性样本也通过一种内部定性逆转录酶（RT）-PCR检测法进行检测，该检测法测得的灵敏度为每毫升少于100个HCV基因组当量。在1239份bDNA阴性标本中，74.1%通过RT-PCR检测为阴性，25.9%为阳性，这表明相当一部分bDNA阴性样本存在病毒血症。我们讨论了这些结果的医学和经济意义，并提出了临床实验室在进行HCV定量检测时可考虑的两种替代方法。对于能够以不超过bDNA检测成本40%的费用进行灵敏RT-PCR检测的实验室，通过RT-PCR对bDNA检测请求进行预筛查可能是最具成本效益的方法。
