ANTİ-HCV POZİTİF SERUM ÖRNEKLERİNDE VİREMİ ORANLARININ VE ANTİ-HCV DÜZEYLERİ İLE İLİŞKİSİNİN ARAŞTIRILMASI

Dünya nüfusunun yaklaşık %3'ünün Hepatit C virüsü (HCV) ile infekte olduğu tahmin edilmektedir. HCV infeksiyonunun tanı ve takibi, serolojik yöntemlerle anti-HCV antikorlarının taranması ve moleküler yöntemlerle HCV-RNA'nın tespitini içerir. HCV antikor testleri, kronik HCV infeksiyonlu hastalarda çok duyarlı ve özgül iken, aktif HCV infeksiyonu ve geçirilmiş infeksiyonu ayırmada yetersiz kalmaktadır. Moleküler yöntemler, aktif HCV replikasyonunu göstermede kullanılan altın standart yöntemler olarak düşünülmektedir. Çalışmamızda, anti-HCV'si pozitif serum örneklerinde HCV-RNA pozitiflik oranlarının ve HCV-RNA pozitifliğinin Anti-HCV düzeyleri (signal sample/cut-off =S/Co) ile ilişkisinin belirlenmesi amaçlanmıştır. Serum örneklerinde anti-HCV, ELISA (Elecsys Anti-HCV II assay, Roche) yöntemi ile incelenmiştir. Anti-HCV pozitif 297 örnekte HCV-RNA araştırılmıştır. HCV-RNA düzeyleri kantitatif gerçek zamanlı PCR (COBAS Ampliprep/ COBAS TaqMan HCV, Roche) yöntemi ile araştırılmıştır. Çalışmamızda, 297 Anti-HCV pozitif serum örneğinin 110'unda (% 37) viremi varlığını doğrulayan HCV-RNA pozitifliği belirlenmiştir. Viremik ve non-viremik serum örnekleri arasında anti-HCV düzeylerinde (S/Co) anlamlı farklılıklar bulunmuştur. Sonuç olarak, Anti-HCV'nin yüksek S/Co değerlerinin HCV-RNA varlığı ile ilişkili olduğu belirlenmiştir. Böylece, HCV-RNA testi yapılmadan önce anti-HCV S/Co değerlerinin bilinmesi, hekimin viremi varlığını önceden tahmin etmesini sağlayacak ve HCV-RNA testlerinin yüksek maliyeti azalabilecektir

Investigation of Viremia Rates and Its Correlation With Anti-HCV Levels in Anti-HCV Positive Serum Samples

It is estimated that about 3 % of the world’s population are infected with Hepatitis C virus (HCV). The diagnosis and follow-up of HCV infection involve screening for anti-HCV antibodies by serological methods and the detection of HCV-RNA by molecular techniques. HCV antibody assays are highly sensitive and specific in patients with chronic HCV infection, where as they failed to distinguish active HCV infection and past infection. Molecular methods are considered the ‘gold standard’ for detecting active HCV replication. In our study, it is aimed to determine HCV-RNA positivity in Anti-HCV positive serum samples and its correlation with anti-HCV levels (signal sample/cut-off =S/Co). Serum samples were assayed for anti-HCV by ELISA method (Elecsys Anti-HCV II assay, Roche). A total of 297 anti-HCV positive samples were tested for HCV-RNA. The level of HCV-RNA was measured by quantitative real-time PCR (COBAS Ampliprep / COBAS TaqMan HCV, Roche). In our study, we found HCV-RNA positivity, which confirms the presence of HCV viremia, in 110 (37 %) of 297 anti-HCV positive serum samples. There were significant differences in anti-HCV levels (S/Co) between viremic and non-viremic serum samples. As a result, it is determined that high S/Co values of anti-HCV related to the presence of HCV-RNA. So, knowing about the S/Co values of anti-HCV before performing HCV-RNA testing might allow the clinician to predict presence of viremia and decrease the highcost of HCV-RNA testing

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  • 1. Alter MJ, Kuhnert WL, Finelli L. Guidelines for laboratory testing and result reporting of antibody to hepatitis C virus. Centers for Disease Control and Prevention, MMWR Recomm Rep 2003;52(RR-3):1-13.
  • 2. Ansari MHK, Omrani MD. Evaluation of Diagnostic Value of Elisa Method (EIA) and PCR in Diagnosis of Hepatitis C Virus In Hemodialysis Patients, Hepatitis Monthly 2006;6:19-23.
  • 3. Baha W, Foullous A, Dersi Net al. Prevalence and risk factors of hepatitis B and C virus infections among the general population and blood donors in Morocco, BMC Public Health 2013;18:50. https://doi.org/10.1186/1471-2458-13-50
  • 4. Cartwright EJ, Rentsch C, Rimland D. Hepatitis C virus screening practices and seropositivity among US veterans born during 1945-1965, BMC Res Notes 2014;14:449. https://doi.org/10.1186/1756-0500-7-449
  • 5. Centers for Disease Control and Prevention, Guidelines for LaboratoryTesting and result reporting, Signal to cut-off ratios for commercially available assays, https://www.cdc.gov/ hepatitis/hcv/labtesting.htm
  • 6. Centers for Disease Control and Prevention, Reference for Interpretation of Hepatitis C Virus (HCV) Test Results, www.cdc.gov/ hepatitis/Resources/OrderPubs/HealthProf/ Ref-IntHCV TestResults_Eng.pdf
  • 7. Cicioğlu Arıdoğan B, Aynali A, Kaya S, Önal S, Sesli Çetin E. Comparison of HCV core antigen and anti-HCV with HCV RNA results, Afr Health Sci 2014;14(4):816-20.
  • 8. Contreras AM, Ochoa-Jiménez RJ,Celis A et al. High antibody level: an accurate serologic marker of viremia in asymptomatic people with hepatitis C infection, Transfusion 2010;50(6):1335-43. https://doi.org/10.1111/j.1537-2995.2009.02571.x
  • 9. Dağlar D, Ergani A, Demirbakan H ve ark. Hemodiyaliz hastalarında Hepatit B ve Hepatit C virüs infeksiyonlarının serolojik ve moleküler yöntemlerle araştırılması, Mikrobiyol Bul 2014;48(1):143-50.
  • 10. De Maria A, Bean CL, Parker MM et al. Centers for disease control and prevention, testing for HCV infection: an update of guidance for clinicians and laboratorians, Morb Mortal Wkly Rep 2013;62(18):362-5.
  • 11. Gökahmetoglu S, Aygen B, Gürsoy Ş, Artan C, Özbel Y, Tapıroğlu T. Anti-HCV pozitif hastalarda HCV-RNA varlığının değerlendirilmesi, Viral Hepatit Derg 2002;8(1):444-6.
  • 12.İnci A, Erus S. Anti HCV pozitif hastalarda HCV RNA sonuçlarının değerlendirilmesi, J Clin Anal Med 2015;6:483-5.
  • 13. Kermani FR, Sharifi Z, Ferdowsian F, Paz Z, Tavassoli F. The usefulness of anti-HCV signal to cut-off ratio in predicting viremia in anti-HCV in patients with Hepatitis C Virus infection, Jundishapur J Microbiol 2015; 18(4):e17841.
  • 14. Kesli R. Evaluation of assay methods and false positive results in the laboratory diagnosis of hepatitis C virus infection, Arch Clin Microbiol 2011;2:1-4.
  • 15. Kopilovic B, Poljak M, Seme K, Klavs I. Hepatitis C virus infection among pregnant women in Slovenia: study on 31,849 samples obtained in four screening rounds during 1999, 2003, 2009 and 2013, Euro Surveill 2015;20(22):21144. https://doi.org/10.2807/1560-7917.ES2015. 20.22.21144
  • 16. Lee CH, Shin HP, Lee JI et al. Predicting factors of present hepatitis C virus infection among patients positive for the hepatitis C virus antibody, Clin Mol Hepatol 2013;19(4):376- 81. https://doi.org/10.3350/cmh.2013.19.4.376 Anti-HCV pozitif serum örneklerinden viremi oranlarının ve anti-HCV düzeyleri ile ilişkisinin araştırılması 13
  • 17. Medicia MC, Chezzi C, De Conto F et al. Evolving strategy for HCV testing in an Italian tertiary care hospital, J Clin Virol 2016;77:92-8. https://doi.org/10.1016/j.jcv.2016.02.017
  • 18. Rondahl E, Gruber M, Joelsson S et al. The risk of HCV RNA contamination in serology screening instruments with a fixed needle for sample transfer, Clin Virol 2014;60(2):172-3. https://doi.org/10.1016/j.jcv.2014.03.011
  • 19.Zhang K, Wang L, Lin G, Li J. Is AntiHepatitis C Virus antibody level an appropriate marker to preclude the need for supplemental testing? Intervirology 2015;58(5): 310-7. https://doi.org/10.1159/000441474