1
|
Affiliation(s)
- Raymond D'Souza
- Digestive Disease Research Centre, Royal London Hospital, Turner Street, London E1 1BB, UK.
| | | |
Collapse
|
2
|
Bell AM, Wagner JL, Barber KE, Stover KR. Elbasvir/Grazoprevir: A Review of the Latest Agent in the Fight against Hepatitis C. Int J Hepatol 2016; 2016:3852126. [PMID: 27403342 PMCID: PMC4925941 DOI: 10.1155/2016/3852126] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 05/24/2016] [Indexed: 12/11/2022] Open
Abstract
Hepatitis C virus (HCV) is estimated to affect up to 150 million people worldwide. Despite worldwide prevalence, treatment modalities prior to 2011 remained suboptimal, with low virologic response rates and intolerable side effect profiles. Fortunately, the landscape of treatment for chronic hepatitis C has rapidly evolved since the introduction of HCV NS3/4 protease inhibitors in 2011. Elbasvir, a NS5A inhibitor, combined with grazoprevir, a NS3/4A protease inhibitor, is the latest FDA-approved therapy for patients with genotype 1 or 4 chronic hepatitis C, with or without compensated cirrhosis. This review will focus on the current literature and clinical evidence supporting elbasvir/grazoprevir as first-line therapy in patients with genotypes 1 and 4 chronic hepatitis C.
Collapse
Affiliation(s)
- Allison M. Bell
- Department of Pharmacy Practice, University of Mississippi School of Pharmacy, Jackson, MS 39216, USA
| | - Jamie L. Wagner
- Department of Pharmacy Practice, University of Mississippi School of Pharmacy, Jackson, MS 39216, USA
| | - Katie E. Barber
- Department of Pharmacy Practice, University of Mississippi School of Pharmacy, Jackson, MS 39216, USA
| | - Kayla R. Stover
- Department of Pharmacy Practice, University of Mississippi School of Pharmacy, Jackson, MS 39216, USA
- Department of Medicine-Infectious Diseases, University of Mississippi Medical Center, Jackson, MS 39216, USA
| |
Collapse
|
3
|
Wreghitt TG, Gandhi MK, Gray JJ, Blagdon J, Rankin A, Coates PB. A case of transfusion-acquired hepatitis C. CLINICAL AND LABORATORY HAEMATOLOGY 2008; 15:141-4. [PMID: 7688679 DOI: 10.1111/j.1365-2257.1993.tb00138.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The Blood Transfusion Service introduced screening for Hepatitis C antibody (HCV) in September 1991. This is done by second generation enzyme linked immunosorbent assay (ELISA) tests. We present a case of post-transfusion hepatitis C hepatitis in a patient with myeloma. Infection was acquired before screening was introduced. Both the patient and the infected blood donor were diagnosed using ELISA assays and the polymerase chain reaction (PCR). In this way we prevented the blood donor from spreading the virus via subsequent blood donations. There were some interesting discrepancies in the HCV assays. Blood samples, when tested by different methods, gave both positive and negative results. The results also varied according to when the blood samples to be tested were taken. The case illustrates the importance of confirming positive results and that no single laboratory test is entirely satisfactory in diagnosing HCV infection.
Collapse
Affiliation(s)
- T G Wreghitt
- Clinical Microbiology and Public Health Laboratory, Addenbrooke's Hospital, Cambridge
| | | | | | | | | | | |
Collapse
|
4
|
Abstract
Liver transplantation is a useful treatment for end stage liver disease of all aetiologies but recurrent disease presents an ongoing challenge, particularly for hepatitis C virus (HCV) where recurrence is almost universal. Immunosuppression is needed for all patients after transplantation and should be tailored to the individual patient, with particular problems being noted for those with HCV. The longer term effects of immunosuppression, particularly renal failure and the adverse effects of certain treatments on the liver graft, have become more important as survival improves and results are studied for longer periods after transplantation.
Collapse
Affiliation(s)
- I Gee
- Department of Gastroenterology, Leicester Royal Infirmary, Leicester LE1 5WW, UK.
| | | |
Collapse
|
5
|
Affiliation(s)
- Raymond D'Souza
- Digestive Disease Research Centre, Royal London Hospital, Turner Street, London E1 1BB, UK.
| | | |
Collapse
|
6
|
Affiliation(s)
- J C Booth
- Department of Gastroenterology, Royal Berkshire Hospital, London Road, Reading RG5 5AN, UK
| | | | | |
Collapse
|
7
|
Affiliation(s)
- J A Murphy
- Department of Haematology, Glasgow Royal Infirmary, UK
| | | | | | | |
Collapse
|
8
|
Abstract
The identification of hepatitis A and hepatitis B led to the recognition that a third virus was capable of causing blood-borne hepatitis. The pathogen responsible for this nonA, nonB hepatitis was identified in the late 1980s and subsequently named hepatitis C. Since the discovery of hepatitis C there has been a pandemic of research publications describing the natural history of the infection and it is now known that this virus can cause serious liver damage in a proportion of infected patients. It is now clear that the effects of infection with hepatitis C and alcohol misuse are additive and that there is an increased risk of hepatic complications in infected patients who abuse alcohol.
Collapse
Affiliation(s)
- J C Booth
- Department of Gastroenterology, Chelsea and Westminster Hospital, London, UK
| |
Collapse
|
9
|
Abstract
Recent isolation, cloning, and sequencing of the hepatitis C genome, which has led to the development of an enzyme-linked immunosorbent assay, has produced increasing recognition of a hepatic disease that frequently leads to potentially lethal, chronic active hepatitis. We describe four patients who had pruritus or in whom pruritus developed as a consequence of hepatitis C. The symptom of pruritus should be added to a growing list of cutaneous manifestations of this newly recognized inflammatory viral hepatitis.
Collapse
Affiliation(s)
- D A Fisher
- University of California Medical Schools, San Francisco
| | | |
Collapse
|
10
|
Abstract
The hepatitis C virus (HCV) has been cloned, and assays capable of detecting antibody to HCV recombinant proteins (anti-HCV) have been developed. Concurrent with the cloning and development of the anti-HCV screening tests, trials with interferon alfa-2b have documented biochemical and histologic improvement in the indices of hepatitis C and non-A, non-B (NANB) in patients who were chronically infected. Subsequently, the anti-HCV assays and interferon alfa-2b have become clinically available. These new detection and treatment modalities can now be used in the management of hemophilics and other chronically transfused patients who bear great risk for blood-borne infections and manifest signs of chronic hepatitis.
Collapse
Affiliation(s)
- L M Aledort
- Mount Sinai Medical Center, New York City, NY 10029-6574
| |
Collapse
|
11
|
Salvaggio A, Conti M, Albano A, Pianetti A, Muggiasca ML, Re M, Salvaggio L. Sexual transmission of hepatitis C virus and HIV-1 infection in female intravenous drug users. Eur J Epidemiol 1993; 9:279-84. [PMID: 7691651 DOI: 10.1007/bf00146264] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We examined the relationship between the presence of antibody to HCV and sexually transmitted diseases in 151 female, intravenous drug users aged 17-43 years. Anti-HCV was present in 49 of 66 HIV-1-negative women (74.2%), and 63 of 85 HIV-1-positive women (74.1%). Anti-HCV seropositivity was significantly related to sexually transmitted infections (Ureaplasma urealyticum infections excluded) in HIV-1-seronegative women, but not in HIV-1-positive women. Also, in HIV-1-negative subjects. Trichomonas vaginalis infections (and infections with M. hominis) were significantly related to anti-HCV seropositivity, and a positive relation between the number of sexual partners and the presence of anti-HCV was demonstrated. In HIV-1-positive subjects a shared use of needles and syringes was more likely, and an increased parenteral exposure to HCV may decrease the relative contribution by sexual transmission. However, in HIV-1-negative subjects, sexual transmission of HCV appears to be both a possible and important means of transmission.
Collapse
Affiliation(s)
- A Salvaggio
- Istituto di Igiene e Medicina Preventiva, Università degli Studi di Milano, Italy
| | | | | | | | | | | | | |
Collapse
|
12
|
Conlon PJ, Walshe JJ, Smyth EG, McNamara EB, Donohoe J, Carmody M. Lower prevalence of anti-hepatitis C antibody in dialysis and renal transplant patients in Ireland. Ir J Med Sci 1993; 162:145-7. [PMID: 7685747 DOI: 10.1007/bf02942105] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
It is well recognised that haemodialysis and renal transplant patients are at increased risk of developing non-A, non-B hepatitis. Recently the genome of hepatitis C virus (HCV), the major causative agent for non-A, non-B hepatitis, has been isolated. Anti-HCV seroprevalence was assessed in all haemodialysis patients (266) in Ireland who in March 1990 had been dialysed for at least 6 months. For comparative purposes, 272 patients who had functioning renal transplants for greater than 6 months were also studied. Potential risk factors such as age, number of blood transfusions and time on dialysis were evaluated. The prevalence of HCV infection as evidenced by antibody detection was only 1.1% for transplant and 1.7% for haemodialysis patients. This compares to a reported incidence of between 10% and 50% found elsewhere. Two of the 5 anti-HCV positive haemodialysis patients and 2 of the 3 transplant patients had biochemical evidence of liver disease. From stored sera it was possible to ascertain when patients acquired HCV. Whether the very low prevalence of anti-HCV in Irish patients is due to the low prevalence of the virus in the general population, the policy of non reimbursement of blood donors, genetic or other factors, remains to be determined.
Collapse
Affiliation(s)
- P J Conlon
- Department of Nephrology, Beaumont Hospital, Dublin, Ireland
| | | | | | | | | | | |
Collapse
|
13
|
Affiliation(s)
- P Gill
- National Reference Laboratory, Canadian Red Cross Society, Ottawa, Ontario
| |
Collapse
|
14
|
|
15
|
Ko YC, Ho MS, Chiang TA, Chang SJ, Chang PY. Tattooing as a risk of hepatitis C virus infection. J Med Virol 1992; 38:288-91. [PMID: 1282147 DOI: 10.1002/jmv.1890380411] [Citation(s) in RCA: 93] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The association of hepatitis C virus (HCV) infection and tattooing was studied in 87 tattooed and 126 tattoo free healthy young men who did not engage in intravenous drug use or multiple sexual activity. Antibody against HCV (anti-HCV) was tested in serum specimens by enzyme immunoassay with C100-3, NS3, and core antigens; 11 of the 87 (12.6%) tattooed and 3 of the 126 (2.4%) tattoo free subjects were positive for anti-HCV (odds ratio = 5.9, 95% CI = 1.6-22.0). A relationship was demonstrated by an increased risk for HCV infection with an increasing number of tattooed site (P(trend) = 0.002). All but one of the 87 tattooed subjects had been infected by hepatitis B virus (HBV) and 25 were carriers of hepatitis B surface antigen (HBsAg). None of the 25 HBsAg carriers was positive for anti-HCV whereas 11 of the 62 HBsAg non-carriers had anti-HCV, suggesting a negative association between the HBsAg carriage and the long lasting anti-HCV (P = 0.02, Fisher's exact). The status of the tattooer was also an important determinant for HCV infection; the risk was higher if tattooing was done by a non-professional friend than by a professional tattooist. Tattooing, probably with improperly sterilized needles, can clearly pose an increased risk for HCV infection in Taiwan. This study indicates the need for legal standards for hygienic tattooing as part of preventive measures for the control of parenterally transmitted infections.
Collapse
Affiliation(s)
- Y C Ko
- School of Public Health, Kaohsiung Medical College, Taiwan
| | | | | | | | | |
Collapse
|
16
|
Rossetti F, Cesaro S, Pizzocchero P, Cadrobbi P, Guido M, Zanesco L. Chronic hepatitis B surface antigen-negative hepatitis after treatment of malignancy. J Pediatr 1992; 121:39-43. [PMID: 1320673 DOI: 10.1016/s0022-3476(05)82538-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
We reviewed the records of all patients with a diagnosis of malignancy who were treated at our center and who had not had chemotherapy for at least 18 months, to assess the prevalence of chronic hepatitis B surface antigen (HBsAg)-negative hepatitis, to assess the prevalence of a marker of hepatitis C virus infection, and to determine the severity of chronic liver disease. Of 557 eligible patients, 38 (6.8%) had chronic HBsAg-negative hepatitis. Of these 38 patients, 20 (52.6%) had a marker of hepatitis C virus infection. The prevalence of chronic HBsAg-negative hepatitis was higher in patients previously treated for leukemia than in patients treated for another malignancy (11.8% vs 4.6%; p = 0.004). The liver biopsy revealed chronic active hepatitis or cirrhosis or both in 8 (28%) of 28 patients with clinical chronic HBsAg-negative hepatitis. Four patients without hepatitis C virus infection who underwent liver biopsy had hepatitis B virus antigen in the liver, confirmed by immunohistochemistry studies. One patient uninfected with hepatitis C virus had hemochromatosis. We conclude that infection with hepatitis C virus was the major cause of chronic HBsAg-negative hepatitis in pediatric patients previously treated for malignancy; the cause remained unidentified in 30% of the patients.
Collapse
Affiliation(s)
- F Rossetti
- Department of Pediatrics, University of Padova, Italy
| | | | | | | | | | | |
Collapse
|
17
|
Dasarathy S, Misra SC, Acharya SK, Irshad M, Joshi YK, Venugopal P, Tandon BN. Prospective controlled study of post-transfusion hepatitis after cardiac surgery in a large referral hospital in India. LIVER 1992; 12:116-20. [PMID: 1323739 DOI: 10.1111/j.1600-0676.1992.tb00568.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
We studied the risk of post-transfusion hepatitis (PTH) in recipients of blood collected from voluntary donors screened for HBsAg. Two hundred and fifty patients without any previous history of liver disease or transfusion were followed up for 12 months subsequent to cardiac surgery. Thirty-five of them had closed-heart surgery without receiving transfusion and served as controls. The remaining 215 patients received single-point transfusions (mean 4 +/- 2.4 units). None of the controls and 15 (6.9%) blood recipients developed PTH. Three (20%) patients had hepatitis-B-virus-induced hepatitis while the remainder (80%) had non A, non B (NANB) hepatitis. The number of units of blood transfused and surrogate markers for development of PTH (donor alanine aminotransferase, anti-HBc and anti-HBs antibody) were not associated with the occurrence of PTH (p greater than 0.05). Nine (60%) of the 15 patients developing PTH were asymptomatic. All the patients recovered from the PTH, except one who died of fulminant hepatitis. At the end of 1 year of follow-up, none of the patients had evidence of chronic hepatitis. Only three (25%) of the patients with NANB-PTH developed anti-hepatitis C virus (HCV) antibody during the follow-up. We conclude that the incidence of PTH in India is similar to other parts of the world and NANB virus was the major cause of the PTH. The absence of chronicity and lack of seroconversion to anti-HCV antibody in the majority of the patients after 1 year of follow-up may suggest the possibility of a NANB virus other than HCV as the major cause of PTH in India.
Collapse
Affiliation(s)
- S Dasarathy
- Department of Gastroenterology and Cardiothoracic Surgery, All India Institute of Medical Sciences, New Delhi
| | | | | | | | | | | | | |
Collapse
|
18
|
Vranckx R, Walckiers D, Stroobant A, Thiers G. Sero epidemiological characteristics of hepatitis C encountered in general practice in Belgium. Eur J Clin Microbiol Infect Dis 1992; 11:62-4. [PMID: 1373384 DOI: 10.1007/bf01971275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A study carried out between 1982 and 1984 established by exclusion diagnosis that 35% of viral hepatitis cases registered in Belgium were due to non A, non B (NANB) viruses. Recently, a new anti-hepatitis C virus (HCV) detection test was used to analyse the sera of patients in whom NANB hepatitis was diagnosed in that study. Using this new serological test for HCV, 29% of the NANB group was found to be positive for anti-HCV. In the 1982-84 study on viral hepatitis diagnosed by general practitioners, the number of clinically recognized infections was estimated at 14,700 (+/- 2,170; confidence interval at 95%) per year. By combining these data and the results of the present study, the following estimates could be calculated: HAV (7,129 +/- 1,054/year), HBV (2,426 +/- 358/year), HCV (1,470 +/- 216/year) and non-identified hepatitis viruses (3,675 +/- 543/year).
Collapse
Affiliation(s)
- R Vranckx
- Institute of Hygiene and Epidemiology, Brussels, Belgium
| | | | | | | |
Collapse
|
19
|
Hallissey MT, Crowson MC, Kiff RS, Kingston RD, Fielding JW. Blood transfusion: an overused resource in colorectal cancer surgery. Ann R Coll Surg Engl 1992; 74:59-62. [PMID: 1736797 PMCID: PMC2497488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The use of blood transfusion was examined in 476 patients who underwent curative surgery for large bowel cancer. Of these patients, 128 were not transfused while 348 received a total of 1174 units of blood. A patient was considered over-transfused if the predischarge haemoglobin was more than 12 g/dl. Using this criteria and accepting that single unit transfusions should be avoided, transfusion could have been avoided in 30% of the patients and a total of 377 units were given unnecessarily. Major under-transfusion did not occur; no patient being discharged with a haemoglobin of less than 9 g/dl. This study shows that blood transfusion is overused and the reasons for its use rarely recorded. In view of the morbidity related to transfusion, it is suggested that surgeons and anaesthetists reappraise their transfusion policy and the first step in this must be to record the reason for transfusion.
Collapse
Affiliation(s)
- M T Hallissey
- Department of Clinical Studies, Park Hospital, Manchester
| | | | | | | | | |
Collapse
|
20
|
Abstract
Significant differences exist in the prevalence of most gastroenterological emergencies in tropical compared with temperate countries. Both ethnic and environmental (often clearly defined geographically) factors are relevant. The major oesophageal lesions which can present acutely in tropical countries are varices and carcinoma; bleeding and obstruction are important sequelae. Peptic ulcer disease (and its complications), often associated (not necessarily causally) with Helicobacter pylori infection, has marked geographical variations in incidence. Emergencies involving the small intestine are dominated by severe dehydration, and its sequelae, resulting from secretory diarrhoea, most notably cholera. However, enteritis necroticans ('pig bel' disease), paralytic ileus (sometimes caused by antiperistaltic agents) and obstruction (secondary to luminal helminths, volvulus and intussusception) are other important problems, especially in infants and children. Enteric fever is occasionally complicated by perforation and haemorrhage; the former (which is notoriously difficult to manage) is accompanied by significant mortality. Ileocaecal tuberculosis is a major cause of right iliac fossa pathology--sometimes associated with malabsorption; amoeboma is an important clinical differential diagnosis. The colon can be involved in invasive Entamoeba histolytica infection (which, like complicated enteric fever, is difficult to manage if the fulminant form, with perforation, ensues), shigellosis, volvulus and intussusception. Acute colonic dilatation occasionally follows Salmonella sp., Shigella sp., Campylobacter jejuni, Yersinia enterocolitica and rarely E. histolytica infections. Acute hepatocellular failure is a major cause of morbidity and mortality in the tropics and subtropics. It usually results from viral hepatitis (HBV, sometimes complicated by HDV, and HCV), but there is a long list of differential diagnoses. Hepatotoxicity resulting from herbs, chemotherapeutic agents or alcohol also occurs not infrequently. Chronic liver disease and its sequelae (often long-term results of viral hepatitis) are commonplace. Haematemesis and hepatocellular failure are usually very difficult to manage due to a lack of sophisticated support techniques in developing countries. Invasive hepatic amoebiasis usually responds well to medical management; however, spontaneous perforation can occur and the consequences of this are serious. Pyogenic liver abscess, although far less common than amoebic 'abscess', carries a bad prognosis whatever the method(s) of management. Hydatidosis and schistosomiasis also involve the liver, and helminthiases are important in the context of biliary tract disease. Gall stones are unusual in most tropical settings. Acute pancreatitis is overall unusual, but chronic calcific pancreatitis can present as an acute abdominal emergency.
Collapse
|
21
|
|
22
|
Tang E. Hepatitis C virus. A review. West J Med 1991; 155:164-8. [PMID: 1656611 PMCID: PMC1002947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Hepatitis C virus has been shown to be responsible for most cases of posttransfusion hepatitis, as well as for sporadic non-A, non-B viral hepatitis. Hepatitis C virus has also been implicated in the development of primary hepatocellular carcinoma, autoimmune hepatitis, and fulminant viral hepatitis. Although the role of the parenteral transmission of hepatitis C virus is well established, its route of transmission in cases of sporadic infection remains unclear. Sexual transmission is suspected but not confirmed. Recent work regarding treatment has shown interferon alfa to be effective, but the discontinuation of therapy is associated with a 50% relapse rate.
Collapse
Affiliation(s)
- E Tang
- University of Southern California School of Medicine, Los Angeles
| |
Collapse
|
23
|
Lim SG, Lee CA, Charman H, Tilsed G, Griffiths PD, Kernoff PB. Hepatitis C antibody assay in a longitudinal study of haemophiliacs. Br J Haematol 1991; 78:398-402. [PMID: 1651756 DOI: 10.1111/j.1365-2141.1991.tb04454.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Stored sera from 28 patients with inherited coagulation disorders who had developed non-A non-B hepatitis (NANBH) following a first exposure to clotting factor concentrates and 15 similar, but unmatched, patients who had received blood products but had normal transaminases on sequential testing were tested using the Ortho enzyme-linked immunosorbent assay (ELISA) anti-HCV assay. Twenty-seven of the 28 patients with NANBH were anti-HCV positive after exposure. In 10 of those in whom dates of first exposure and seroconversion were well-defined, the median time interval to NANBH was 4 weeks (range 1-7) and to anti-HCV seroconversion was 11 weeks (range 7.5-14.5). None of the 15 patients without NANBH developed anti-HCV. This first generation Ortho ELISA anti-HCV assay showed 96% sensitivity and 100% specificity and has potential use as an adjunct in the surveillance of new clotting factor products.
Collapse
Affiliation(s)
- S G Lim
- Haemophilia Centre, Royal Free Hospital, London
| | | | | | | | | | | |
Collapse
|
24
|
Guadagnino V, Foca A, Caroleo B, Colao F, Izzi A, Berlinghieri M, Lucia A, Meliado A, Morabito D. Anti-HCV antibodies in institutionalized psychiatric patients. Med Mal Infect 1991. [DOI: 10.1016/s0399-077x(05)80146-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
25
|
Tor J, Llibre JM, Carbonell M, Muga R, Ribera A, Soriano V, Clotet B, Sabriá M, Foz M. Sexual transmission of hepatitis C virus and its relation with hepatitis B virus and HIV. BMJ (CLINICAL RESEARCH ED.) 1990; 301:1130-3. [PMID: 2174705 PMCID: PMC1664292 DOI: 10.1136/bmj.301.6761.1130] [Citation(s) in RCA: 97] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To determine the extent of transmission of hepatitis C virus in sexual partners of intravenous drug misusers and to examine the relation between the prevalences of HIV, hepatitis B virus, and hepatitis C virus infections in homosexual men and intravenous drug misusers and their sexual partners. DESIGN Serum samples collected between 1984 and 1988 were tested for hepatitis B virus markers and antibodies against hepatitis C virus by enzyme linked immunosorbent assay (ELISA) and for HIV antibody by enzyme immune analysis and western blotting. SETTING Large referral university hospital with an external AIDS clinic in the metropolitan area of Barcelona, Spain. SUBJECTS 243 Intravenous drug misusers, 143 of their regular heterosexual partners, and 105 homosexual men. MAIN OUTCOME MEASURES Prevalences of hepatitis C virus, hepatitis B virus, and HIV infections. RESULTS In all, 178 of the 243 (73%) intravenous drug misusers, 16 out of 143 (11%) of their partners, and 17 of the 105 (16%) homosexual men had antibodies against hepatitis C virus. The presence of hepatitis C virus infection was unrelated to sex, age, the presence of HIV or hepatitis B virus infections, or the Centers for Disease Control stage of HIV. In sexual partners of intravenous drug misusers there were strong correlations between the presence of hepatitis C virus infection and that of HIV (p = 0.001) and hepatitis B virus (p = 0.013) infections. CONCLUSIONS Intravenous drug misusers have a high risk of acquiring hepatitis C virus, hepatitis B virus, and HIV infections, but the presence of hepatitis C virus infection seems to be unrelated to the presence of the other two viruses. Homosexual men have a high prevalence of HIV and hepatitis B virus infections with a low prevalence of hepatitis C virus infection, the presence of which is not related to that of the other two infections. Conversely, heterosexual partners of intravenous drug misusers have low prevalences of the three virus infections, but the presence of hepatitis C virus infection correlates significantly with the presence of HIV and hepatitis B infections. The rate of sexual transmission of hepatitis C virus seems to be low, even in partners of people known to be seropositive for this virus.
Collapse
Affiliation(s)
- J Tor
- Infectious Diseases Unit, Germans Trias i Pujol Hospital, Autonomous University of Barcelona, Spain
| | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Affiliation(s)
- R M Kliegman
- Department of Pediatrics, Case Western Reserve University, Rainbow Babies and Childrens Hospital, Cleveland, OH 44106
| |
Collapse
|
27
|
Schrumpf E, Elgjo K, Fausa O, Haukenes G, Kvale D, Rollag H. The significance of anti-hepatitis C virus antibodies measured in chronic liver disease. Scand J Gastroenterol 1990; 25:1169-74. [PMID: 2177219 DOI: 10.3109/00365529008998550] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The frequency of hepatitic C virus (HCV) antibodies was determined in two different laboratories in stored sera from 128 consecutive patients with chronic liver disease and from 41 healthy blood donors. Repeated measurements were performed in most patients. At the first determination the frequency of HCV antibodies was 7% in primary sclerosing cholangitis, 42% in primary biliary cirrhosis, 40% in autoimmune chronic active hepatitis, and 27% in alcoholic liver disease. The reproducibility of the determinations was rather poor, with a within-assay variation of 9.9%, whereas the between-assay variation was 34% and 47% in the two laboratories. There was a significant difference in the results obtained in the controls, depending on the handling of the sera. Freezing and thawing and, possibly, protracted storing of sera had a major impact on the assay and may have invalidated the results obtained in many studies. A significant association between IgG levels and titers of HCV antibodies was found in the total group of patients (p less than 0.005), in autoimmune chronic active hepatitis (p less than 0.005), and in primary biliary cirrhosis (p less than 0.01). It may be questioned whether the assay really is specific for anti-HCV antibodies in these patients. Whether HCV has anything to do with the etiology and pathogenesis of chronic liver disease apart from NANB-hepatitis is still undetermined.
Collapse
Affiliation(s)
- E Schrumpf
- Dept. of Medicine A, Rikshospitalet, Oslo, Norway
| | | | | | | | | | | |
Collapse
|
28
|
|