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Comparison of Methodologies for Quantification of Hepatitis C Virus (HCV) RNA
in Patients
Coinfected with HCV and Human Immunodeficiency Virus
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Clinical Infectious Diseases 2002;35:482-487
Kenneth E. Sherman,1 Susan D. Rouster,1 and Paul S. Horn2 Department of
Medicine, Division of
Digestive Diseases, University of Cincinnati College of Medicine, and
2Department of
Mathematical Sciences, University of Cincinnati, Ohio
Quantification of hepatitis C virus (HCV) RNA is important in the assessment
of HCV-associated
liver disease in patients coinfected with HCV and human immunodeficiency
virus (HIV). To
investigate whether the standard integrity of competing test methodologies
might be
compromised by higher HCV titers in coinfected patients, 2 technologies (a
polymerase chain
reactionbased assay [COBAS Amplicor 2.0 assay; Roche Diagnostics] and a
branched-chain DNA
assay [Versant 3.0; Bayer]) were evaluated by testing paired serum samples
from 68 coinfected
patients and 137 HCV-monoinfected patients. Although the correlation was
highly significant (r =
0.81; P < .001), HCV RNA titers expressed in international units per
milliliter could not be standardized; statistically significant differences
were observed in all quartiles. Significant
variability (P < .0007) was observed in the classification of patients as
having a high versus a low
virus titer (cutoff, 800,000 IU/mL), which suggests that standardization in
international units has
low efficacy among coinfected patients. Clinicians should note that test
variability precludes direct comparability of HCV RNA titers, particularly in
coinfected patients with high titers.
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