Polymerase chain reaction [PCR] is it essential for diagnosis of hepatitis C virus [HCV] infection?

ABSTRACT

36 patients [mostly Egyptians] with elevated levels of transaminases [mean +/- SD = 11.516 +/- 47.99 and 90.73 +/- 35.89 for ALT and AST, respectively], and anti-HCV +ve as detected by second generation ELISA. Recombinant immunoblot assay [LiaTek HCV-III] and polymerase chain reaction [PCR] were used as confirmatory tests. The study showed that 94.4% of ELISA-II positive were confirmed by recombinant immunoblot assay [LiaTek HCV-III] while PCR showed positivity in 91.6% of ELISA-II positive. All ELISA-II positives that were confirmed by LiaTek HCV-III or PCR had ELISA ratio more than 5 and no significant differences were found between the two confirmatory tests regarding the mean ELISA ratio [10.5 +/- 2.05 vs 10.67 +/- 1.83], respectively, or between either tests and ELISA-II [mean +/- SD = 10.02 +/- 2.83]. From this study, it may be concluded that HCV infection can be diagnosed in most cases by ELISA-II especially in those cases with ELISA ratio of more than 5. If confirmation is needed, it can be performed by recombinant immunoblot assay [LiaTek HCV-III]. So, either ELISA-II or LiaTek HCV-III can replace the more expensive and sophisticated technique PCR as a confirmatory test for diagnosis of HCV infection. The PCR can be reserved for defining the time and course of HCV viremia, follow up patients under interferon therapy and for rapid diagnosis of acute hepatitis C, before appearance of HCV antibodies