Heidrich B, Pischke S, Helfritz F A, Mederacke I, Kirschner J, Schneider J, Raupach R, Jäckel E, Barg-Hock H, Lehner F, Klempnauer J, von Hahn T, Cornberg M, Manns M P, Ciesek S, Wedemeyer H
Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany; Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical School, Hannover, Germany.
J Viral Hepat. 2014 Nov;21(11):769-79. doi: 10.1111/jvh.12204. Epub 2013 Nov 19.
HCV RNA levels correlate with the long-term outcome of hepatitis C in liver transplant recipients. Nucleic acid testing (NAT) is usually used to confirm HCV reinfection and to examine viral loads after liver transplantation. HCV core antigen (HCVcoreAg) testing could be an alternative to NAT with some potential advantages including very low intra- and interassay variabilities and lower costs. The performance of HCVcoreAg testing in organ transplant recipients is unknown. We prospectively studied 1011 sera for HCV RNA and HCVcoreAg in a routine real-world setting including 222 samples obtained from patients after liver or kidney transplantation. HCV RNA and HCVcoreAg test results showed a consistency of 98% with a very good correlation in transplanted patients (r > 0.85). The correlation between HCV RNA and HCVcoreAg was higher in sera with high viral loads and in samples from patients with low biochemical disease. Patients treated with tacrolimus showed a better correlation between both parameters than individuals receiving cyclosporine A. HCV RNA/HCVcoreAg ratios did not differ between transplanted and nontransplanted patients, and HCV RNA and HCVcoreAg kinetics were almost identical during the first days after liver transplantation. HCVcoreAg testing can be used to monitor HCV viral loads in patients after organ transplantation. However, the assay is not recommended to monitor antiviral therapies.
丙型肝炎病毒（HCV）RNA水平与肝移植受者丙型肝炎的长期预后相关。核酸检测（NAT）通常用于确认HCV再感染以及检测肝移植后的病毒载量。HCV核心抗原（HCVcoreAg）检测可能是NAT的一种替代方法，具有一些潜在优势，包括极低的批内和批间变异以及更低的成本。HCVcoreAg检测在器官移植受者中的性能尚不清楚。我们在常规实际环境中对1011份血清进行了HCV RNA和HCVcoreAg的前瞻性研究，其中包括从肝或肾移植患者中获得的222份样本。HCV RNA和HCVcoreAg检测结果显示一致性为98%，在移植患者中具有非常好的相关性（r>0.85）。在病毒载量高的血清以及生化疾病程度低的患者样本中，HCV RNA与HCVcoreAg之间的相关性更高。接受他克莫司治疗的患者在这两个参数之间的相关性比接受环孢素A的个体更好。移植患者与未移植患者之间的HCV RNA/HCVcoreAg比值没有差异，并且在肝移植后的头几天内，HCV RNA和HCVcoreAg的动力学几乎相同。HCVcoreAg检测可用于监测器官移植后患者的HCV病毒载量。然而，不建议使用该检测来监测抗病毒治疗。
