Mateo R, Demetris A, Sico E, Frye C, Wang L F, el-Sakhawi Y, Reilly M, Ehrlich G D, Cooper D, Fung J
Medical College of Pennsylvania, Department of General Surgery, Pittsburgh.
Surgery. 1993 Aug;114(2):442-8.
Reverse transcriptase polymerase chain reaction (RT-PCR) can detect the viral genome and show hepatitis C recurrence in patients who undergo transplantation for chronic hepatitis C viral (HCV) infection. We investigated the utility of an RT-PCR-based HCV assay for early detection of viral RNA in de novo HCV infection after liver transplantation.
Pretransplantation antibodies and explanation HCV viral RNA status were obtained from 117 patients. Follow-up liver biopsy specimens were examined for evidence of hepatitis activity. Plasma samples during the period of time of the biopsy were assayed for HCV antibody and viral RNA. RNA was extracted from samples and reverse transcribed to cDNA. cDNA was amplified by PCR, and products were detected by liquid hybridization.
Clinical hepatitis developed in seventeen of 117 patients who, before transplantation, were HCV antibody negative and explant viral RNA negative. Ten patients were plasma PCR negative and had known non-hepatitis C causes for the biopsy findings. Of the remaining seven patients, five (70%) were plasma RT-PCR positive before seroconversion in matched plasma samples.
In liver transplant patients, the incidence of de novo clinical hepatitis is low, and HCV viral RNA in de novo clinical hepatitis C infection can be detected in the absence of HCV antibodies.
逆转录聚合酶链反应（RT-PCR）可检测病毒基因组，并显示慢性丙型肝炎病毒（HCV）感染患者移植后丙型肝炎复发情况。我们研究了基于RT-PCR的HCV检测方法在肝移植后新发HCV感染中早期检测病毒RNA的效用。
获取117例患者移植前的抗体及解释HCV病毒RNA状态。对随访肝活检标本检查肝炎活动证据。在活检期间采集的血浆样本检测HCV抗体和病毒RNA。从样本中提取RNA并逆转录为cDNA。通过PCR扩增cDNA，产物通过液相杂交检测。
117例移植前HCV抗体阴性且移植肝病毒RNA阴性的患者中有17例发生临床肝炎。10例患者血浆PCR阴性，活检结果有已知非丙型肝炎病因。其余7例患者中，5例（70%）在匹配血浆样本血清转化前血浆RT-PCR阳性。
在肝移植患者中，新发临床肝炎的发生率较低，新发丙型肝炎病毒感染中的HCV病毒RNA可在无HCV抗体的情况下检测到。
