Effective detection of active HCV infection: HCV RNA carrier state in a context free of hepatitis symptoms

HCV immunological assays have limited specificity due to considerable variability of genomic coding sequences. Accordingly, PCR RNA detection also shows variable incidence of HCV in a non-A, non-B (NANB) hepatitis context. We used in-house designed nested PCR applying primers from the 5′ untranslated region in 150 thalassemic patients classified in four groups according to anti-HCV screening and glutamic-pyruvate transaminase (GPT) levels. Group A: anti-HCV +/high GPT levels; group B: anti-HCV +/normal GPT levels; group C: anti-HCV −/high GPT levels; group D: anti-HCV −/normal GPT levels. Viral incidence and concentration, both high in group A, decreased towards group D. Group C RNA incidence was unexpectedly high and, moreover, one control case proved HCV-RNA +. Compared with the Amplicor kit our primers were considerably more sensitive.