Anti-HCV Core Protein Monoclonal antibody, Clone 3G7[Rhodamine]

The small pool of donors has required the use of anti-HBc positive donors, with the resulting possibility of transmitting hepatitis B virus (HBV) from these organs. However, the availability of suitable prophylactic regimens has made the use of anti-HBc positive organs feasible. The use of organs from HBV-surface antigen (HBsAG) carriers or actively HBV-infected individuals is more complex and requires an individual risk-benefit analysis. Grafts from hepatitis C (HCV)-positive donors continues to be the subject of debate. New interferon-free regimens containing direct-acting antiviral agents have fewer adverse effects and better efficacy, making HCV treatment feasible early after transplantation. Thus, solid organ transplantation from HCV positive/-viremic donors must be re-examined, whereby HCV-positive describes the serologic proof of resolved infection and HCV-viremic or -infected an actively replicating infection with proof of HCV-RNA. With interferon-free regimens for HCV infection, expanding the donor pool by including HCV-positive organs is an interesting option that could substantially decrease waiting times and mortality rates for patients listed for transplantation. This review discusses available data, challenges and benefits of using HBV- and HCV-positive and -viremic donor organs in the advent of new antiviral therapeutic options.

Background. With the advent of highly efficient antiviral therapies for hepatitis C virus (HCV) infection, providing broad access to diagnosis and care is needed. The dried blood spot (DBS) technique can be used to collect, store, and ship whole-blood specimens. Our goal was to assess the performance of standardized HCV diagnostic and monitoring tools in the analysis of DBS. Methods. Serum specimens and whole-blood specimens collected using the DBS technique from > 500 patients were tested for virological markers used to diagnose and monitor HCV infection. Results. Enzyme immunoassay detection of anti-HCV antibodies in specimens from DBS was reliable after establishment of a new signal-to-cutoff ratio. HCV RNA was detected DBS from the vast majority of patients with active replication, but HCV RNA levels were substantially lower than in serum specimens, implying that only the presence or absence of HCV RNA or changes in the HCV RNA level should be taken into consideration for therapy. Detection of HCV core antigen in specimens from DBS was not a sensitive marker of chronic HCV infection. HCV genotype determination was possible in the vast majority of DBS. Conclusions. This study shows that whole-blood pecimens collected using the DBS technique can be confidently used to diagnose and monitor HCV infection. DBS could help improve access to care for HCV infection because they are suitable for use in large-scale screening programs, diagnosis, and therapeutic monitoring.