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Journal of Clinical Microbiology, February 2000, p. 888-891, Vol. 38, No. 2
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Hepatitis C Virus Quantitation: Optimization of Strategies for Detecting Low-Level Viremia

Wolfgang T. Hofgärtner,dagger Jeffrey A. Kant, and Karen E. Weck*

Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania

Received 7 July 1999/Returned for modification 21 September 1999/Accepted 22 November 1999

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.

* Corresponding author. Mailing address: University of Pittsburgh, Department of Pathology, Division of Molecular Diagnostics, Scaife Hall, 7th floor, 3550 Terrace St., Pittsburgh, PA 15213-2500. Phone: (412) 648-8519. Fax: (412) 383-9594. E-mail: weckke{at}msx.upmc.edu.

dagger Present address: Becton Dickinson UK Limited, Cowley, Oxford OX43LY, United Kingdom.

Journal of Clinical Microbiology, February 2000, p. 888-891, Vol. 38, No. 2
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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