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Khattab MA, Zakaria Y, Sadek E, Abd EL Fatah AS, Fouad M, Khattab M, Moness HM, Adel NM, Ahmed E. Detection of hepatitis C virus (HCV) RNA in the peripheral blood mononuclear cells of HCV-infected patients following sustained virologic response. Clin Exp Med 2023; 23:131-140. [PMID: 35066710 PMCID: PMC9939488 DOI: 10.1007/s10238-022-00791-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 01/04/2022] [Indexed: 11/03/2022]
Abstract
It is unclear whether direct-acting antiviral drugs (DAAs) result in the complete eradication of HCV infection or whether some quantities of the virus may persist after achieving a sustained virologic response (SVR). Aim The aim of this work was to study the possibility of the persistence of HCV RNA in peripheral blood mononuclear cells (PBMCs) after achieving SVR following DAA treatment. This study included 100 patients infected with HCV genotype 4, who were candidates for receiving DAAs and who achieved SVR during follow-up, as determined at 12 and/or 24 weeks following the end of treatment. All patients were subjected to demographic, biochemical and hematological assessments. Detection of HCV RNA in the serum and PBMCs and determination of the HCV genotype were performed with real-time PCR. We detected HCV RNA in the PBMCs of 20 out of 100 (20%) patients infected with HCV genotype 4, who achieved SVR. However, the persistent viral load in the PBMCs was very low (range: 400-900 U/mL; mean ± SD: 645.45 ± 153 U/mL). Multiple logistic regression analysis showed that only the higher posttreatment levels of aspartate transaminase (AST) were significantly predictive of HCV RNA persistence in the PBMCs (OR: 1.29; 95% CI: 1.08-1.55). Additionally, according to the Cox proportional hazard model, liver cirrhosis was the only significant risk factor for the persistence of HCV infection in PBMCs (HR: 5.8; 95% CI: 1.3-26.1; P < 0.02). Our results indicated the persistence of HCV RNA in some HCV patients who achieved SVR after treatment with DAAs.
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Affiliation(s)
- Mahmoud A. Khattab
- grid.411806.a0000 0000 8999 4945Present Address: Internal Medicine Department, Faculty of Medicine, Minia University, Cornish Al-Nile Road, PO: 61111, Minia, Egypt
| | - Yehia Zakaria
- grid.411806.a0000 0000 8999 4945Present Address: Internal Medicine Department, Faculty of Medicine, Minia University, Cornish Al-Nile Road, PO: 61111, Minia, Egypt
| | - Eslam Sadek
- grid.411806.a0000 0000 8999 4945Present Address: Internal Medicine Department, Faculty of Medicine, Minia University, Cornish Al-Nile Road, PO: 61111, Minia, Egypt
| | - Aliaa S. Abd EL Fatah
- grid.411806.a0000 0000 8999 4945Present Address: Internal Medicine Department, Faculty of Medicine, Minia University, Cornish Al-Nile Road, PO: 61111, Minia, Egypt
| | - Magdy Fouad
- grid.411806.a0000 0000 8999 4945Tropical Medicine Department, Faculty of Medicine, Minia University, PO: 61111, Minia, Egypt
| | - Muhammed Khattab
- grid.411806.a0000 0000 8999 4945Department of General Surgery, Hepatobiliary Unit, Faculty of Medicine, Minia University, PO: 61111, Minia, Egypt
| | - Hend M. Moness
- grid.411806.a0000 0000 8999 4945Clinical Pathology Department, Faculty of Medicine, Minia University, PO: 61111, Minia, Egypt
| | - Nashwa Mohamed Adel
- grid.411806.a0000 0000 8999 4945Radio Diagnosis Department, Minia University, PO: 61111, Minia, Egypt
| | - Elham Ahmed
- grid.411806.a0000 0000 8999 4945Present Address: Internal Medicine Department, Faculty of Medicine, Minia University, Cornish Al-Nile Road, PO: 61111, Minia, Egypt
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Ondigui JLN, Kenmoe S, Kengne-Ndé C, Ebogo-Belobo JT, Takuissu GR, Kenfack-Momo R, Mbaga DS, Tchatchouang S, Kenfack-Zanguim J, Fogang RL, Menkem EZ, Kame-Ngasse GI, Magoudjou-Pekam JN, Bowo-Ngandji A, Goumkwa NM, Esemu SN, Ndip L, Essama SHR, Torimiro J. Epidemiology of occult hepatitis B and C in Africa: A Systematic Review and Meta-analysis. J Infect Public Health 2022; 15:1436-1445. [DOI: 10.1016/j.jiph.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022] Open
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Mbaga DS, Kenmoe S, Njiki Bikoï J, Takuissu GR, Amougou-Atsama M, Atenguena Okobalemba E, Ebogo-Belobo JT, Bowo-Ngandji A, Oyono MG, Magoudjou-Pekam JN, Kame-Ngasse GI, Nka AD, Feudjio AF, Zemnou-Tepap C, Adamou Velhima E, Ndzie Ondigui JL, Nayang-Mundo RA, Touangnou-Chamda SA, Kamtchueng Takeu Y, Taya-Fokou JB, Mbongue Mikangue CA, Kenfack-Momo R, Kengne-Ndé C, Sake CS, Esemu SN, Njouom R, Ndip L, Riwom Essama SH. Global prevalence of occult hepatitis C virus: A systematic review and meta-analysis. World J Methodol 2022; 12:179-190. [PMID: 35721241 PMCID: PMC9157636 DOI: 10.5662/wjm.v12.i3.179] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/03/2022] [Accepted: 04/30/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Occult hepatitis C infection (OCI) is characterized by the presence of hepatitis C virus (HCV) RNA in the liver, peripheral blood mononuclear cells (PBMC) and/or ultracentrifuged serum in the absence of detectable HCV-RNA in serum. OCI has been described in several categories of populations including hemodialysis patients, patients with a sustained virological response, immunocompromised individuals, patients with abnormal hepatic function, and apparently healthy subjects.
AIM To highlight the global prevalence of OCI.
METHODS We performed a systematic and comprehensive literature search in the following 4 electronic databases PubMed, EMBASE, Global Index Medicus, and Web of Science up to 6th May 2021 to retrieve relevant studies published in the field. Included studies were unrestricted population categories with known RNA status in serum, PBMC, liver tissue and/or ultracentrifuged serum. Data were extracted independently by each author and the Hoy et al tool was used to assess the quality of the included studies. We used the random-effect meta-analysis model to estimate the proportions of OCI and their 95% confidence intervals (95%CI). The Cochran's Q-test and the I2 test statistics were used to assess heterogeneity between studies. Funnel plot and Egger test were used to examine publication bias. R software version 4.1.0 was used for all analyses.
RESULTS The electronic search resulted in 3950 articles. We obtained 102 prevalence data from 85 included studies. The pooled prevalence of seronegative OCI was estimated to be 9.61% (95%CI: 6.84-12.73) with substantial heterogeneity [I² = 94.7% (95%CI: 93.8%-95.4%), P < 0.0001]. Seropositive OCI prevalence was estimated to be 13.39% (95%CI: 7.85-19.99) with substantial heterogeneity [I2 = 93.0% (90.8%-94.7%)]. Higher seronegative OCI prevalence was found in Southern Europe and Northern Africa, and in patients with abnormal liver function, hematological disorders, and kidney diseases. Higher seropositive OCI prevalence was found in Southern Europe, Northern America, and Northern Africa.
CONCLUSION In conclusion, in the present study, it appears that the burden of OCI is high and variable across the different regions and population categories. Further studies on OCI are needed to assess the transmissibility, clinical significance, long-term outcome, and need for treatment.
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Affiliation(s)
- Donatien Serge Mbaga
- Department of Microbiology, The University of Yaounde I, Yaounde 00237, Cameroon
| | - Sebastien Kenmoe
- Department of Microbiology and Parasitology, University of Buea, Buea 00237, Cameroon
- Department of Virology, Centre Pasteur of Cameroon, Yaounde 00237, Cameroon
| | - Jacky Njiki Bikoï
- Department of Microbiology, The University of Yaounde I, Yaounde 00237, Cameroon
| | - Guy Roussel Takuissu
- Centre of Research in Food, Food Security and Nutrition, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon
| | - Marie Amougou-Atsama
- Centre de Recherche sur les Maladies Emergentes et Re-Emergentes, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon
| | | | - Jean Thierry Ebogo-Belobo
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon
| | - Arnol Bowo-Ngandji
- Department of Microbiology, The University of Yaounde I, Yaounde 00237, Cameroon
| | - Martin Gael Oyono
- Laboratory of Parasitology and Ecology, The University of Yaounde I, Yaounde 00237, Cameroon
| | | | - Ginette Irma Kame-Ngasse
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon
| | - Alex Durand Nka
- Virology Laboratory, Chantal Biya International Reference Center for Research on HIV/AIDS Prevention and Management, Yaounde 00237, Cameroon
| | | | - Cromwel Zemnou-Tepap
- Department of Biochemistry, The University of Yaounde I, Yaounde 00237, Cameroon
| | - Elie Adamou Velhima
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon
| | | | | | | | - Yrene Kamtchueng Takeu
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon
| | | | | | - Raoul Kenfack-Momo
- Department of Biochemistry, The University of Yaounde I, Yaounde 00237, Cameroon
| | - Cyprien Kengne-Ndé
- Epidemiological Surveillance, Evaluation and Research Unit, National Aids Control Committee, Douala 00237, Cameroon
| | | | - Seraphine Nkie Esemu
- Department of Microbiology and Parasitology, University of Buea, Buea 00237, Cameroon
| | - Richard Njouom
- Department of Virology, Centre Pasteur of Cameroon, Yaounde 00237, Cameroon
| | - Lucy Ndip
- Department of Microbiology and Parasitology, University of Buea, Buea 00237, Cameroon
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Hassnine A, Saad Z. Rome IV Diagnostic Criteria for Functional Gastrointestinal Disorders in Patients with Chronic Hepatitis C Virus. Middle East J Dig Dis 2022; 14:214-221. [PMID: 36619155 PMCID: PMC9489310 DOI: 10.34172/mejdd.2022.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 02/01/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND: Patients with chronic hepatitis C virus (HCV) usually have different abdominal complaints without any organic lesions. The functional cause of these complaints is claimed in most patients. This study aimed to evaluate functional gastrointestinal disorders (FGIDs) in patients with chronic hepatitis C using Rome IV diagnostic criteria. METHODS: This study included 1506 participants (1006 patients with chronic HCV, and 500 controls). All individuals were subjected to taking thorough medical history, basic investigations (complete blood counts, liver and renal functions tests), international normalized ratio (INR), alpha-fetoprotein, HCV RNA PCR (polymerase chain reaction), abdominal ultrasonography, and upper gastrointestinal tract (GIT) endoscopy for patients only), and Rome IV diagnostic questionnaire. RESULTS: Patients with HCV had symptoms of FGIDs including functional dyspepsia (FD) (P=0.009), early satiety (P=0.002), postprandial distress (P=0.02), epigastric pain (P=0.03), Inflammatory bowel syndrome (IBS) (P<0.001), IBS predominant constipation (P<0.001), IBS predominant diarrhea (P<0.001), and IBS mixed (P<0.001). There were multiple factors for the prediction of FD in patients with HCV, including high body mass index (BMI), education level, positive polymerase chain reaction (PCR), and fibrosis stage. Also, there were multiple factors for the prediction of IBS in patients with HCV, including male gender, high BMI, urban residence, education level, positive PCR, and fibrosis stage. CONCLUSIONS: FD is a prevalent finding in obese patients with HCV and with higher fibrosis scores. IBS is also prevalent in male patients with HCV.
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Affiliation(s)
- Alshymaa Hassnine
- Corresponding Author: Alshymaa Hassnine, MD Department of gastroenterology, and tropical Medicine,Minia University, Minia, Egypt. Tel: 00201092004294
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SARS-CoV-2 Infection in Iranian People Living with Human Immunodeficiency Virus-1 Infection. Jundishapur J Microbiol 2022. [DOI: 10.5812/jjm.121929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: A novel Coronavirus first emerging in Wuhan, China, was named severe acute respiratory syndrome Coronavirus 2 (SARS‐CoV‐2). The disease caused by SARS‐CoV‐2 is known as Coronavirus disease 2019 (COVID‐19). HIV-1 infected individuals may be at risk of COVID-19. Objectives: This cross-sectional study evaluated the SARS-CoV-2 infection rate and COVID-19 prevalence among Iranian HIV-1-infected people. Methods: The study was conducted on 155 HIV-1-infected patients from June 2020 to October 2020. COVID-19 Ab (IgG) was detected using an enzyme immunoassay in serum specimens. Furthermore, nasopharyngeal and oropharyngeal specimens were collected. Then, the genomic RNA of SARS‐CoV‐2 was detected using a real-time polymerase chain reaction (RT-PCR). Clinical symptoms of the studied participants with and without COVID-19 were examined. Results: Of 155 HIV-1-infected individuals, 12 (7.7%) had positive real-time PCR results for SARS-CoV-2. Out of 12 (7.7%) patients with COVID‐19, four (33.3%) were males. Anti-COVID Ab (IgG) was detected in 10 (6.5%) participants, of whom eight (80.0%) were males. The most common COVID-19 clinical symptoms, including dry cough, fever, runny nose, anosmia, and hypogeusia, were observed in seven (58.3%), five (41.7%), five (41.7%), five (41.7%), and five (41.7%) patients with COVID-19, respectively. Conclusions: A recent study has shown that the risk of SARS‐CoV‐2 infection in HIV-infected individuals is similar to that in the general population.
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Lotfi AA, Mohamed AE, Shalaby NA, Eissa DS, El-Dabaa E, Sallam AM, Kamel MM, Abdelaziz H, El-Afifi AM, Abdel-Moneim AS. Occult hepatitis C virus infection in patients with malignant lymphoproliferative disorders. Int J Immunopathol Pharmacol 2021; 34:2058738420961202. [PMID: 33045856 PMCID: PMC7557643 DOI: 10.1177/2058738420961202] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Despite the link between HCV and malignant lymphoproliferative disorders has been established, the association between occult hepatitis C virus infection and malignant lymphoproliferative disorders remains obscure. The present study intended to identify the possible association between occult HCV infection and malignant lymphoproliferative disorders. Newly diagnosed patients with LPDs were screened for the presence of HCV-RNA in both plasma and PBMCs. PBMCs of the subjects were also, examined by transmission and immuno-electron microscopy. LPD patients showed a high percentage of HCV infection (71.9%): OCI-HCV (37.5%) and HCV (34.38%). Meanwhile, 28.13% of LPD patients did not show any evidence of HCV infection. Ultrastructural examination of PBMCs revealed the presence of intracytoplasmic vacuoles enclosing viral like particles, which were less prominent in occult HCV patients. The possibility of occult HCV should be considered in patients with LPDs which can be helpful in the management of the treatment protocol in order to set up a balance between the control of the tumor progression and minimizing post chemotherapy complications related to HCV infection.
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Affiliation(s)
- Abeya A Lotfi
- Clinical and Chemical Pathology Department, Theodor Bilharz Research Institute, Giza, Egypt
| | - Asmaa E Mohamed
- Clinical and Chemical Pathology Department, Theodor Bilharz Research Institute, Giza, Egypt
| | - Nahela A Shalaby
- Clinical and Chemical Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Deena S Eissa
- Clinical and Chemical Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ehab El-Dabaa
- Biochemistry and Molecular biology department, Theodor Bilharz Research Institute, Giza, Egypt
| | - Ayman M Sallam
- Biochemistry and Molecular biology department, Theodor Bilharz Research Institute, Giza, Egypt
| | - Mahmoud M Kamel
- Clinical Pathology Department, National Cancer Institute, Cairo University, Giza, Egypt
| | - Hisham Abdelaziz
- Clinical Pathology Department, National Cancer Institute, Cairo University, Giza, Egypt
| | - Amal M El-Afifi
- Department of Clinical hematology and transplantation, Ain shams University, Cairo, Egypt
| | - Ahmed S Abdel-Moneim
- Microbiology Department, College of Medicine, Taif University, Taif, Saudi Arabia.,Virology Department, Faculty of Veterinary Medicine, Beni-Suef University, Beni-Suef, Egypt
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Hepatitis C viral RNA in blood mononuclear cells of patients treated with directly acting antivirals. Arab J Gastroenterol 2021; 22:158-163. [PMID: 33820724 DOI: 10.1016/j.ajg.2021.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 02/02/2021] [Accepted: 03/01/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND STUDY AIMS Occult hepatitis C viral infection (OCI) may have serious complications, such as relapse, ongoing histological impairment, hepatic decompensation, hepatocellular carcinoma, and the possible risk of transmission. This study was conducted to assess the occurrence and prevalence of secondary OCI in patients with chronic hepatitis C viral infection (HCV) who received a complete course of directly acting antivirals (DAAs). PATIENTS AND METHODS Antiviral therapy consisted of sofosbuvir + daclatasvir ± ribavirin for 12 weeks to 90 treatment-naive, compensated, chronic HCV patients. Plasma and peripheral blood mononuclear cells (PBMCs) were tested for HCV RNA viral load by quantitative, reverse transcription, real-time PCR at 8, 12 (Group I, n = 45), and 24 (Group II, n = 45) weeks after treatment initiation. RESULTS By week 8, only 2 and 7 patients were positive for HCV RNA in plasma and PBMCs, respectively. No HCV RNA was detected by weeks 12 or 24 in the PBMCs of Groups I and II, respectively. Older age was significantly associated with HCV RNA positivity in plasma and PBMCs (n = 8) at week 8 compared with HCV RNA negativity (n = 82). No other significant differences were observed for any other variables. CONCLUSION The development of secondary OCI among easy-to-treat patients following a full course of DAA treatment doesn't exist, hence, we do not recommend testing the HCV RNA in the PBMCs after complete course of treatment in this patient category. The detection of HCV RNA in PBMCs is recommended as a confirmatory test of cure following a shortened DAA treatment regimen.
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Hedayati-Moghaddam MR, Soltanian H, Ahmadi-Ghezeldasht S. Occult hepatitis C virus infection in the Middle East and Eastern Mediterranean countries: A systematic review and meta-analysis. World J Hepatol 2021; 13:242-260. [PMID: 33708353 PMCID: PMC7934012 DOI: 10.4254/wjh.v13.i2.242] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/25/2020] [Accepted: 12/08/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The presence of hepatitis C virus (HCV) RNA in liver tissue or peripheral blood mononuclear cells with no identified virus genome in the serum has been reported worldwide among patients with either normal or elevated serum liver enzymes. The characterization of occult HCV infection (OCI) epidemiology in the Middle East and Eastern Mediterranean (M and E) countries, a region with the highest incidence and prevalence rates of HCV infection in the world, would be effective for more appropriate control of the infection.
AIM To estimate the pooled prevalence of OCI in M and E countries using a systematic review and meta-analysis.
METHODS A systematic literature search was performed using international, regional and local electronic databases. Some conference proceedings and references from bibliographies were also reviewed manually. The search was carried out during May and June 2020. Original observational surveys were considered if they assessed the prevalence of OCI among the population of M and E countries by examination of HCV nucleic acid in peripheral blood mononuclear cells in at least 30 cases selected by random or non-random sampling methods. The meta-analysis was performed using Comprehensive Meta-analysis software based on heterogeneity assessed by Cochran’s Q test and I-square statistics. Data were considered statistically significant at a P value < 0.05.
RESULTS A total of 116 non-duplicated citations were found in electronic sources and grey literature. A total of 51 non-overlapping original surveys were appraised, of which 37 met the inclusion criteria and were included in the analysis. Data were available from 5 of 26 countries including Egypt, Iran, Pakistan, Saudi Arabia, and Turkey. The overall prevalence rate of OCI was estimated at 10.04% (95%CI: 7.66%-13.05%). The lowest OCI rate was observed among healthy subjects (4.79%, 95%CI: 2.86%-7.93%). The higher rates were estimated for patients suffering from chronic liver diseases (12.04%, 95%CI: 5.87%-23.10%), and multi-transfused patients (8.71%, 95%CI: 6.05%-12.39%). Subgroup analysis indicated that the OCI rates were probably not associated with the studied subpopulations, country, year of study, the detection method of HCV RNA, sample size, patients’ HCV serostatus, and sex (all P > 0.05). Meta-regression analyses showed no significant time trends in OCI rates among different groups.
CONCLUSION This review estimated high rates of OCI prevalence in M and E countries, especially among multi-transfused patients as well as patients with chronic liver diseases.
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Affiliation(s)
- Mohammad Reza Hedayati-Moghaddam
- Blood Borne Infections Research Center, Academic Center for Education, Culture and Research (ACECR), Razavi Khorasan Branch, Mashhad 91779-49367, Iran
| | - Hossein Soltanian
- Blood Borne Infections Research Center, Academic Center for Education, Culture and Research (ACECR), Razavi Khorasan Branch, Mashhad 91779-49367, Iran
| | - Sanaz Ahmadi-Ghezeldasht
- Blood Borne Infections Research Center, Academic Center for Education, Culture and Research (ACECR), Razavi Khorasan Branch, Mashhad 91779-49367, Iran
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Jamshidi S, Bokharaei-Salim F, Esghaei M, Bastani MN, Garshasbi S, Chavoshpour S, Dehghani-Dehej F, Fakhim S, Khanaliha K. Occult HCV and occult HBV coinfection in Iranian human immunodeficiency virus-infected individuals. J Med Virol 2020; 92:3354-3364. [PMID: 32232978 DOI: 10.1002/jmv.25808] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/01/2020] [Accepted: 03/17/2020] [Indexed: 12/12/2022]
Abstract
The presence of hepatitis C virus (HCV) genome in liver biopsy or peripheral blood mononuclear cell (PBMC) specimens in the absence of detectable HCV-RNA in plasma of the people with or without anti-HCV antibodies has defined as occult HCV infection (OCI), whereas occult hepatitis B virus infection (OBI) is detection of hepatitis B virus (HBV) genome in the absence of traceable hepatitis B surface antigen in the plasma samples of patients. The purpose of this study is to determine the presence of OBI and OCI in human immunodeficiency virus (HIV)-infected individuals. In this cross-sectional research, 190 Iranian HIV-infected individuals were enrolled from September 2015 to February 2019. All participants were tested regarding various serological markers for HCV and HBV infections. Viral RNA and DNA were extracted from plasma and PBMC specimens, and the presence of HCV-RNA in plasma and PBMC samples was tested using reverse transcriptase-nested polymerase chain reaction (PCR), HBV viral load was determined in plasma samples using COBAS TaqMan 48 Kit, and also the presence of the HBV-DNA in PBMC samples was tested by real-time PCR. In this study, the prevalence of OBI and OCI in HIV-infected individuals was 3.1% and 11.4%, respectively. The genotypes of HCV in the patients with OCI were as follows: 57.1% were infected with subtype 3a, 35.7% were infected with subtype 1a, and 7.1% was infected with subtype 1b. It is noteworthy that in this study, two patients (1.1%) had OCI/OBI coinfections. The present study revealed that 1.1% of Iranian HIV-infected individuals had OBI and OCI at the same time. Therefore, it seems that designing prospective surveys to determine the presence of this coinfection in HIV-infected individuals is informative.
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Affiliation(s)
- Sogol Jamshidi
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Farah Bokharaei-Salim
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Esghaei
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Navid Bastani
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Saba Garshasbi
- Vice Chancellor for Health, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Sara Chavoshpour
- Department of Virology, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | | | - Shahin Fakhim
- Department of Civil Engineering, Faculty of Engineering, Payame Noor University, Karaj, Iran
| | - Khadijeh Khanaliha
- Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
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Dale JM, Hood SP, Bowen O, Bright H, Cutler KL, Berry N, Almond N, Goldin R, Karayiannis P, Rose NJ. Development of hepatic pathology in GBV-B-infected red-bellied tamarins (Saguinus labiatus). J Med Virol 2020; 92:3584-3595. [PMID: 32181899 DOI: 10.1002/jmv.25769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 03/14/2020] [Indexed: 01/08/2023]
Abstract
GB virus B (GBV-B) is a new world monkey-associated flavivirus used to model acute hepatitis C virus (HCV) infection. Critical for evaluation of antiviral or vaccine approaches is an understanding of the effect of HCV on the liver at different stages of infection. In the absence of longitudinal human tissue samples at defined time points, we have characterized changes in tamarins. As early as 2 weeks post-infection histological changes were noticeable, and these were established in all animals by 6 weeks. Despite high levels of liver-associated viral RNA, there was reversal of hepatic damage on clearance of peripheral virus though fibrosis was demonstrated in four tamarins. Notably, viral RNA burden in the liver dropped to near undetectable or background levels in all animals which underwent a second viral challenge, highlighting the efficacy of the immune response in removing foci of replication in the liver. These data add to the knowledge of GBV-B infection in New World primates which can offer attractive systems for the testing of prophylactic and therapeutic treatments and the evaluation of their utility in preventing or reversing liver pathology.
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Affiliation(s)
- Jessica M Dale
- Division of Virology, National Institute for Biological Standards and Control, Medicine and Healthcare products Regulatory Agency, Blanche Lane, South Mimms, Potters Bar, Hertfordshire, UK
| | - Simon P Hood
- Division of Virology, National Institute for Biological Standards and Control, Medicine and Healthcare products Regulatory Agency, Blanche Lane, South Mimms, Potters Bar, Hertfordshire, UK
| | - Ori Bowen
- Division of Virology, National Institute for Biological Standards and Control, Medicine and Healthcare products Regulatory Agency, Blanche Lane, South Mimms, Potters Bar, Hertfordshire, UK
| | - Helen Bright
- Internal Medicine Research Unit, Pfizer Research and Development, Sandwich, Kent, UK
| | - Keith L Cutler
- Division of Virology, National Institute for Biological Standards and Control, Medicine and Healthcare products Regulatory Agency, Blanche Lane, South Mimms, Potters Bar, Hertfordshire, UK
| | - Neil Berry
- Division of Virology, National Institute for Biological Standards and Control, Medicine and Healthcare products Regulatory Agency, Blanche Lane, South Mimms, Potters Bar, Hertfordshire, UK
| | - Neil Almond
- Division of Virology, National Institute for Biological Standards and Control, Medicine and Healthcare products Regulatory Agency, Blanche Lane, South Mimms, Potters Bar, Hertfordshire, UK
| | - Robert Goldin
- Department of Cellular Pathology, Imperial College London, St. Mary's Campus, Norfolk Place, London, UK
| | - Peter Karayiannis
- Department of Medicine, Imperial College London, St. Mary's Campus, Norfolk Place, London, UK
| | - Nicola J Rose
- Division of Virology, National Institute for Biological Standards and Control, Medicine and Healthcare products Regulatory Agency, Blanche Lane, South Mimms, Potters Bar, Hertfordshire, UK
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11
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Alduraywish A, Ragheb M, Taher I, Louis N, Aldossari K, Kishk R. Prevalence, risk factors and impact of occult HCV infection on liver morbidity among haemodialysis patients: hospital-based cross-sectional study. Scand J Gastroenterol 2020; 55:963-969. [PMID: 32649843 DOI: 10.1080/00365521.2020.1790649] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Haemodialysis (HD) patients are at risk for blood-borne infections as occult HCV infection, which justifies comprehensive studies. We aimed to determine the prevalence and risk factors of occult HCV infection (OCI) among HD patients. MATERIAL AND METHODS One hundred eligible HD patients, with no evidence of overt HCV or HBV and HBV vaccinated were recruited, and tested for HCV, HBV markers and HCV RNA. Two HCV-positive patients were excluded and peripheral mononuclear cells of 98 patients were verified for viraemia. RESULTS OCI was detected in eight (8.16%); with a median viral load of 7010copies/ml. Their mean age was 30.63 (±18.87 years) compared to others (41.73 ± 15.93) (p = .069). History of surgery, dental procedure, and blood transfusion was comparably high in both groups (p > .05). All OCI patients underwent dialysis twice weekly compared to 48.9% of non-OCI patients (p = .006). OCI patients had a significantly higher mean duration of dialysis (12.63 ± 6.74 years), and a significantly higher frequency (50%) of HCV Ab compared to 6.48 ± 4.76, and 10%, respectively, in non-OCI patients. None of OCI patients was reactive to HBcAb compared to 34 (37.8%) patients without (p = .048). Evidence of liver morbidity was detected in 5 (62.5%) OCI patients compared to 43 (47.7%) of non-OCI patients (p > .05). CONCLUSION Among our HD patients, OCI is considered a comorbid finding associated with mild liver morbidity that warrants strict infection control and periodic testing for blood borne infections.
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Affiliation(s)
| | - Mostafa Ragheb
- Department of Endemic and Infectious Diseases, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Ibrahim Taher
- Department of Pathology, Faculty of Medicine, Jouf University, Skaka, Saudi Arabia
| | - Nageh Louis
- Department of Endemic and Infectious Diseases, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Khaled Aldossari
- Department of Family and Community Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Rania Kishk
- Department of Microbiology and Immunology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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12
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Yaroslavtseva NG, Tikhomirov DS, Nikolaeva LI, Dedova AV, Ovchinnikova EN, Misko ON, Romanova TY, Makhnovskiy PI, Grishechkin AE, Tupoleva TA. [Low concentrations of hepatitis C virus RNA in serologically mild infection.]. Vopr Virusol 2020; 64:30-35. [PMID: 30893527 DOI: 10.18821/0507-4088-2019-64-1-30-35] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 03/06/2018] [Indexed: 11/17/2022]
Abstract
Occult HCV infection (OCI) provides significant interest recently. HCV RNA in this case can be detected not in plasma, but in blood cells and/or in liver tissue. In case of antibody genesis impairment anti-HCV detection may lead to negative or "uncertain" result. The aim of the study was to estimate infection type in blood donors and patients with hematological diseases by exploration of samples with uncertain anti-HCV detection results. Blood samples of 30 180 potential blood donors' and 4322 patients with hematological diseases were tested. Comparative analysis of wide pattern of HCV markers was performed. 33 blood donors and 42 patients were enrolled in follow-up examination. Uncertain results of Anti-HCV detection in donors' samples were in 0.18% of cases. Follow-up examination of 33 donors provided discordant results using immunochemiluminescence assay and ELISA. 15.2% donors' samples contained HCV RNA in low concentration. Follow-up observation of 42 patients with incomplete antiviral antibody pattern showed HCV RNA presence in 40.5% cases (21.4% high viremia and 19.0% low viremia). Samples with low RNA concentration contained low titers of anti-core antibodies. Samples with high titers of anti-core antibodies contained high HCV RNA level. Uncertain results of anti-HCV in 15.2% of potential blood donors' samples were confirmed by detection of HCV RNA in low concentration. It proved OCI presence in these individuals and called for testing for wide pattern of HCV markers in addition to routine screening. Patients with hematological diseases showed low level of HCV RNA along with low titers of antibodies against one or two viral antigens.
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Affiliation(s)
- N G Yaroslavtseva
- National Medical Research Center of Hematology, 125167, Moscow, Russian Federation
| | - D S Tikhomirov
- National Medical Research Center of Hematology, 125167, Moscow, Russian Federation
| | - L I Nikolaeva
- D.I. Ivanovsky Institute of Virology «National Research Center of Epidemiology and Microbiology named after the honorary academician N.F. Gamaleya», 123098, Moscow, Russian Federation
| | - A V Dedova
- D.I. Ivanovsky Institute of Virology «National Research Center of Epidemiology and Microbiology named after the honorary academician N.F. Gamaleya», 123098, Moscow, Russian Federation
| | - E N Ovchinnikova
- National Medical Research Center of Hematology, 125167, Moscow, Russian Federation
| | - O N Misko
- National Medical Research Center of Hematology, 125167, Moscow, Russian Federation
| | - T Yu Romanova
- National Medical Research Center of Hematology, 125167, Moscow, Russian Federation
| | - P I Makhnovskiy
- D.I. Ivanovsky Institute of Virology «National Research Center of Epidemiology and Microbiology named after the honorary academician N.F. Gamaleya», 123098, Moscow, Russian Federation
| | - A E Grishechkin
- D.I. Ivanovsky Institute of Virology «National Research Center of Epidemiology and Microbiology named after the honorary academician N.F. Gamaleya», 123098, Moscow, Russian Federation
| | - T A Tupoleva
- National Medical Research Center of Hematology, 125167, Moscow, Russian Federation
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Nafari AH, Ayadi A, Noormohamadi Z, Sakhaee F, Vaziri F, Siadat SD, Fateh A. Occult hepatitis C virus infection in hemophilia patients and its correlation with interferon lambda 3 and 4 polymorphisms. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2020; 79:104144. [PMID: 31838260 DOI: 10.1016/j.meegid.2019.104144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/05/2019] [Accepted: 12/12/2019] [Indexed: 12/11/2022]
Abstract
Occult HCV infection (OCI) is described as the presence of HCV RNA in the liver and peripheral blood mononuclear cells (PBMCs), with no HCV RNA in the serum. Single-nucleotide polymorphisms (SNPs) near interferon lambda 3/4 (IFNL3/4) gene are associated with spontaneous clearance and treatment response in patients with hepatitis C virus (HCV) infection. In this study, we evaluated the frequency of OCI in hemophilia patients and determined the association of three IFNL3 SNPs (rs12979860, rs12980275, and rs8099917) and IFNL4 ss469415590 with OCI positivity. A total of 450 hemophilia patients with HCV negative markers were included in this study. Positive- and negative-stranded HCV-RNA was determined in peripheral blood mononuclear cells (PBMCs) samples by reverse-transcription polymerase chain reaction (RT-PCR) method. IFNL3 SNPs and IFNL4 ss469415590 were genotyped by PCR-RFLP and TaqMan® Real-Time PCR methods, respectively. The frequency of OCI was estimated at 10.2%. Among 46 OCI patients, 56.5%, 23.9%, and 19.6% were infected with HCV-1b, HCV-1a, and HCV-3a, respectively. Compared to patients without OCI, unfavorable IFNL3 rs12979860 TT, IFNL3 rs8099917 GG, IFNL3 rs12980275 GG, and IFNL4 ss469415590 ∆G/∆G genotypes were more frequently reported in OCI patients. The multivariate logistic regression analysis showed that alanine aminotransferase (ALT), cholesterol, triglyceride, IFNL3 rs12979860 (TT), IFNL3 rs8099917 (GG), IFNL3 rs12980275 (GG), and IFNL4 ss469415590 (∆G/∆G) were associated with OCI positivity. In conclusion, we studied the incidence of OCI in Iranian patients with hemophilia for the first time. Our results demonstrated that unfavorable genotypes of IFNL3 SNPs and IFNL4 ss469415590 have a strong relationship with OCI positivity. It seems that the host immune response plays a vital role in OCI positivity.
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Affiliation(s)
- Amir Hossein Nafari
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Ahmad Ayadi
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Zahra Noormohamadi
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Fatemeh Sakhaee
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran
| | - Farzam Vaziri
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran; Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran
| | - Seyed Davar Siadat
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran; Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran
| | - Abolfazl Fateh
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran; Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran.
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Agi E, Asghari S, Namvar A, Khairkhah N, Naderi N, Anvar A, Azizi Saraji A, Bolhassani A. Molecular Study of Occult Hepatitis C Infection among Iranian Hemophilia Patients Treated with Direct-acting Antiviral Agents. JOURNAL OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASES 2020. [DOI: 10.29252/jommid.8.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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15
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Barros RPC, Scotti L, Scotti MT. Exploring Secondary Metabolites Database of Apocynaceae, Menispermaceae, and Annonaceae to Select Potential Anti-HCV Compounds. Curr Top Med Chem 2019; 19:900-913. [PMID: 31074368 DOI: 10.2174/1568026619666190510094228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 03/27/2019] [Accepted: 03/27/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Hepatitis C is a disease that constitutes a serious global health problem, is often asymptomatic and difficult to diagnose and about 60-80% of infected patients develop chronic diseases over time. As there is no vaccine against hepatitis C virus (HCV), developing new cheap treatments is a big challenge. OBJECTIVE The search for new drugs from natural products has been outstanding in recent years. The aim of this study was to combine structure-based and ligand-based virtual screening (VS) techniques to select potentially active molecules against four HCV target proteins from in-house secondary metabolite dataset (SistematX). MATERIALS AND METHODS From the ChEMBL database, we selected four sets of 1199, 355, 290 and 237chemical structures with inhibitory activity against different targets of HCV to create random forest models with an accuracy value higher than 82% for cross-validation and test sets. Afterward, a ligandbased virtual screen of the entire 1848 secondary metabolites database stored in SistematX was performed. In addition, a structure-based virtual screening was also performed for the same set of secondary metabolites using molecular docking. RESULTS Finally, using consensus analyses approach combining ligand-based and structure-based VS, three alkaloids were selected as potential anti-HCV compounds. CONCLUSION The selected structures are a starting point for further studies in order to develop new anti- HCV compounds based on natural products.
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Affiliation(s)
- Renata P C Barros
- Post-Graduate Program in Natural Synthetic Bioactive Products, Federal University of Paraiba, Joao Pessoa, Brazil
| | - Luciana Scotti
- Post-Graduate Program in Natural Synthetic Bioactive Products, Federal University of Paraiba, Joao Pessoa, Brazil
| | - Marcus T Scotti
- Post-Graduate Program in Natural Synthetic Bioactive Products, Federal University of Paraiba, Joao Pessoa, Brazil
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16
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Ayadi A, Nafari AH, Sakhaee F, Rajabi K, Ghaderi Y, Rahimi Jamnani F, Vaziri F, Siadat SD, Fateh A. Host genetic factors and clinical parameters influencing the occult hepatitis C virus infection in patients on chronic hemodialysis: Is it still a controversial infection? Hepatol Res 2019; 49:605-616. [PMID: 30821879 DOI: 10.1111/hepr.13325] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/04/2019] [Accepted: 02/21/2019] [Indexed: 12/11/2022]
Abstract
AIM The presence of occult hepatitis C virus (HCV) infection (OCI) is still controversial, however, this infection cannot be ignored. Therefore, the current study aimed at assessing the OCI frequency in patients on chronic hemodialysis (CHD) and also evaluating the association between OCI incidence with clinical parameters and interferon lambda 3/4 (IFNL3/4) gene polymorphisms. METHODS A total of 515 patients on CHD and HCV negative markers were selected. Plus- and minus-stranded HCV-RNA was tested in peripheral blood mononuclear cell samples by reverse transcription-polymerase chain reaction and then genotyped using the restriction fragment length polymorphism method. RESULTS The frequency of OCI was 11.3% in patients on CHD. Among 58 patients with OCI, 25.8%, 62.1%, and 12.1% were infected with HCV-1a, HCV-1b, and HCV-3a, respectively. The mean alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase levels were 31.9 ± 24.8, 32.3 ± 19.1, and 171.6 ± 88.9, respectively. None of the patients with OCI had a history of liver disease. Multivariate logistic regression analysis indicated that cholesterol, triglyceride, low-density lipoprotein, 25-hydroxyvitamin D, platelets, duration of hemodialysis, HCV subtypes, IFNL3 rs12979860 TT, IFNL3 rs8099917 GG, IFNL3 rs12980275 GG, and IFNL4 ss469415590 ΔG/ΔG genotypes were associated with OCI. CONCLUSION There was a moderate prevalence of OCI in Iranian patients on CHD. The current study findings indicated that this infection was associated with clinical parameters and unfavorable genotypes of IFNL3 single nucleotide polymorphisms and IFNL4 ss469415590. Further studies are required to determine the correlation between OCI incidence with clinical parameters and host genetic factors.
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Affiliation(s)
- Ahmad Ayadi
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Amir Hossein Nafari
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Fatemeh Sakhaee
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran.,Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran
| | - Kimia Rajabi
- Department of Microbiology, Islamic Azad University, Pharmaceutical, Sciences Branch, Tehran, Iran
| | - Yaser Ghaderi
- Islamic Azad University Central Tehran Branch, Faculty of Basic Science, Tehran, Iran
| | - Fatemeh Rahimi Jamnani
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran.,Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran
| | - Farzam Vaziri
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran.,Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran
| | - Seyed Davar Siadat
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran.,Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran
| | - Abolfazl Fateh
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran.,Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran
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17
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Wadood M, Usman M. Comparative Analysis of Electrochemiluminescence Assay and Chemiluminescent Microparticle Immunoassay for the Screening of Hepatitis C. Indian J Hematol Blood Transfus 2019; 35:131-136. [PMID: 30828160 DOI: 10.1007/s12288-018-0968-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 05/12/2018] [Indexed: 11/29/2022] Open
Abstract
The primary objective of the study was to identify a highly sensitive and specific screening technique for the detection of Hepatitis C infection in healthy blood donors in a low prevalence area for HCV. In this study, two of the most commonly used methods for Anti-HCV screening, i.e., Electrochemiluminescence Immunoassay (ECLIA) and Chemiluminescent Microparticle Immunoassay (CMIA) were performed among 517 selected healthy blood donors. The clinical performance of ECLIA and CMIA was compared on the basis of their operational variables, i.e., Sensitivity, Specificity, Accuracy, Youden's J index, Positive and Negative predictive values and False discovery, False positive and False negative rate, etc., Both ECLIA and CMIA are highly sensitive (100%) and specific (98%) in terms of anti HCV detection among the blood donors. According to the clinical performance of ECLIA and CMIA, both are efficient in detecting anti-HCV antibodies among the asymptomatic population of healthy blood donors. But as both of them are associated with false positive results, it is recommended to have Polymerase chain reaction on the reactive samples to detect the HCV RNA.
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Affiliation(s)
- Maeesa Wadood
- 1Department of Pathology and Hematology, Institute of Hematology, Baqai Medical University, 51, Deh Tor, Gadap Road, Near Toll Plaza, Super Highway, P.O Box No 2407, Karachi, 74600 Pakistan.,Muhammadi Blood Bank and Thalassemia Centre, Karachi, Pakistan
| | - Muhammad Usman
- 1Department of Pathology and Hematology, Institute of Hematology, Baqai Medical University, 51, Deh Tor, Gadap Road, Near Toll Plaza, Super Highway, P.O Box No 2407, Karachi, 74600 Pakistan.,Muhammadi Blood Bank and Thalassemia Centre, Karachi, Pakistan
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18
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Mekky MA, Sayed HI, Abdelmalek MO, Saleh MA, Osman OA, Osman HA, Morsy KH, Hetta HF. Prevalence and predictors of occult hepatitis C virus infection among Egyptian patients who achieved sustained virologic response to sofosbuvir/daclatasvir therapy: a multi-center study. Infect Drug Resist 2019; 12:273-279. [PMID: 30774394 PMCID: PMC6348965 DOI: 10.2147/idr.s181638] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background Occult hepatitis C virus (HCV) infection (OCI) is characterized by the detection of HCV-RNA in non-serum reservoirs, such as peripheral blood mononuclear cells (PBMCs) and/or hepatocytes with undetectable HCV-RNA or antibodies in the serum. In this study, we tried to evaluate the prevalence and possible predictors of OCI in patients who achieved sustained virologic response (SVR) post sofosbuvir/daclatasvir (SOF/DCV) therapy. Patients and methods A cross-sectional multicenter study was designed to enroll 1,280 HCV-infected patients who received SOF (400 mg) plus DCV (60 mg) once daily ± ribavirin regimen for 12 weeks and achieved SVR 12 weeks post treatment. They were randomly recruited from three dedicated Egyptian centers for management of HCV. Real-time PCR was performed to detect HCV-RNA in serum and PBMCs and to evaluate the different risk factors pertaining to the existence of OCI. Results HCV-RNA was detected in PBMCs of 50 (3.9%) of them. All OCI cases exhibited significant fibrosis score and raised pre-treatment alanine aminotransferase (ALT) levels. Logistic regression analysis comparing OCI with non-OCI revealed that high pre-treatment viral load, raised ALT, advanced fibrosis score, prolonged prothrombin time, low albumin, Child B score, antiviral experienced patients, and raised bilirubin are the most significant predictor for the possibility of OCI presence with Odds Ratio as 7.03, 5.13, 4.4, 2.68, 2.52, 1.9, 1.5, and 1.2, respectively. Conclusion In spite of its remote possibility, OCI post SOF/DCV therapy may be present in some cases, and this may entail a re-auditing for the definition of SVR by dual testing in both serum and PBMCs.
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Affiliation(s)
- Mohamed A Mekky
- Department of Tropical Medicine and Gastroenterology, Assiut University Hospital, Assiut, Egypt
| | - Hani I Sayed
- Center for Management of Viral Hepatitis, Ministry of Health, Assiut, Egypt
| | - Mohamed O Abdelmalek
- Department of Tropical Medicine and Gastroenterology, Assiut University Hospital, Assiut, Egypt
| | - Medhat A Saleh
- Department of Public Health and Community Medicine, Assiut University, Assiut, Egypt
| | - Osman A Osman
- Department of Tropical Medicine and Gastroenterology, Assiut University Hospital, Assiut, Egypt
| | - Heba A Osman
- Department of Tropical Medicine and Gastroenterology, South Valley University Hospital, Qena, Egypt
| | - Khairy H Morsy
- Department of Tropical Medicine and Gastroenterology, Sohag University Hospital, Sohag, Egypt
| | - Helal F Hetta
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt, .,Department of Internal Medicine, University of Cincinnati Medical Center, Cincinnati, OH, USA,
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19
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Molecular diagnosis of occult hepatitis C virus infection in Iranian injection drug users. Arch Virol 2018; 164:349-357. [PMID: 30390150 DOI: 10.1007/s00705-018-4066-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 09/20/2018] [Indexed: 12/12/2022]
Abstract
Occult HCV infection (OCI) has been described as the presence of hepatitis C virus (HCV) genomic RNA in hepatocytes and/or peripheral blood mononuclear cell (PBMC) specimens and the lack of HCV genomic RNA and anti-HCV antibodies (Abs) in plasma samples. Injection drug users (IDUs) are the most important high-risk group for infection with blood-borne viruses, particularly HCV. The purpose of this study was to determine the presence of OCI in IDUs. A prospective cross-sectional study of 126 consecutive Iranian IDUs was performed from March 2017 to January 2018. PBMCs were separated from blood samples from the participants, and after extraction of the viral RNA from the plasma and PBMC specimens, HCV RNA was detected in the samples using RT-nested PCR by amplification of the 5'-NTR of HCV. HCV genotyping was carried out using restriction a fragment length polymorphism (RFLP) assay. The viral RNA was amplified using RT-nested PCR with specific primers for the NS5B gene, and the PCR products were sequenced to confirm the results obtained by HCV RNA detection and HCV genotyping. Out of the 126 IDUs studied, 105 (83.3%) were negative for anti-HCV Abs and HCV RNA in plasma samples, whereas HCV RNA was detected in the PBMC samples of six (5.7%) participants, indicating that these individuals had OCI. Moreover, HCV genomic RNA was detected in PBMC samples from five (23.8%) of the 21 IDUs studied who were positive for anti-HCV Abs and negative for HCV genomic RNA in plasma specimens. These IDUs also had OCI. The HCV genotypes in the PBMC samples from the subjects with OCI were determined. Six (54.5%) subjects were infected with HCV subtype 3a, and five (45.5%) were infected with HCV subtype 1a. This study showed that 8.7% of the Iranian IDUs had OCI, and therefore, a study focusing on the diagnosis of OCI in these individuals can be valuable and informative.
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Martínez-Rodríguez MDLL, Uribe-Noguez LA, Arroyo-Anduiza CI, Mata-Marin JA, Benitez-Arvizu G, Portillo-López ML, Ocaña-Mondragón A. Prevalence and risk factors of Occult Hepatitis C infections in blood donors from Mexico City. PLoS One 2018; 13:e0205659. [PMID: 30339689 PMCID: PMC6195272 DOI: 10.1371/journal.pone.0205659] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 09/30/2018] [Indexed: 12/16/2022] Open
Abstract
Background The circulatory system is the main mechanism for transmission of the Hepatitis C Virus (HCV). A new class of HCV infections, Occult HCV infection (OCI), is defined as the presence of HCV-RNA in hepatocytes with the absence of HCV in the serum/plasma utilizing current laboratory assays. Different groups have reported the prevalence of OCI; however, its associated risk factors have not been established. In Mexico, there are no reports about OCI, so the objective of our study was to determine the prevalence of OCI in total blood donors in Mexico City, as well as its associated risk factors. Methods Blood donors that were considered eligible for donation, according to NOM 253-SSA1-2012, were randomly selected. Demographic data was collected from 1,037 donors. Plasma and peripheral blood mononuclear cells were assessed for HCV-RNA. The presence of HCV-RNA was determined by nested PCR for the 5'-UTR region. Logistic regression was used to calculate the odds ratio (OR) and 95% confidence interval (95%CI) to determine the level of association. Results The prevalence of OCI was 3.4% among blood donors. Homosexual relationships (OR = 5.52, 95%CI: 1.53–19.92, p<0.05) and acupuncture (OR = 3.56, 95%CI: 1.41–8.98, p<0.05) were significantly associated with OCI. Conclusion There is a significant presence of OCI in the blood donor population in Mexico City. The main risk factors for OCI transmission are homosexual relationships and acupuncture. This study supports the increased use of sensitive and specific screening tests for blood bank testing.
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Affiliation(s)
- María de la Luz Martínez-Rodríguez
- Unidad de Investigación Médica en Inmunología e Infectología, Centro Médico Nacional “La Raza”, Delegación 2 Noreste del D.F., Instituto Mexicano del Seguro Social, Mexico City, Mexico
- * E-mail:
| | - Luis A. Uribe-Noguez
- Unidad de Investigación Médica en Inmunología e Infectología, Centro Médico Nacional “La Raza”, Delegación 2 Noreste del D.F., Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Carla I. Arroyo-Anduiza
- Banco Central de Sangre, Centro Médico Nacional “La Raza”, Delegación 2 Noreste del D.F., Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - José Antonio Mata-Marin
- Hospital de Infectología, Centro Médico Nacional “La Raza”, Delegación 2 Noreste del D.F., Instituto Mexicano del Seguro Social. Mexico City, Mexico
| | - Gamaliel Benitez-Arvizu
- Banco Central de Sangre, Centro Médico Nacional “Siglo XXI”, Delegación Sur, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - María L. Portillo-López
- Banco Central de Sangre, Centro Médico Nacional “Siglo XXI”, Delegación Sur, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Alicia Ocaña-Mondragón
- Unidad de Investigación Médica en Inmunología e Infectología, Centro Médico Nacional “La Raza”, Delegación 2 Noreste del D.F., Instituto Mexicano del Seguro Social, Mexico City, Mexico
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Yaghobi R, Kazemi MJ, Geramizadeh B, Malek Hosseini SA, Moayedi J. Significance of Occult Hepatitis C Virus Infection in Liver Transplant Patients With Cryptogenic Cirrhosis. EXP CLIN TRANSPLANT 2018; 18:206-209. [PMID: 30346262 DOI: 10.6002/ect.2017.0332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Investigations into the viral causes of end-stage liver disease in liver transplant patients with cryptogenic underlying disease remain of interest. Hepatitis C virus infection, especially in its silent (occult) form, may play a key role in the introduction and development of cryptogenic cirrhosis. We aimed to determine the prevalence of occult hepatitis C virus infection in liver transplant recipients with cryptogenic cirrhosis. MATERIALS AND METHODS In this cross-sectional study, 127 liver transplant recipients confirmed to have cryptogenic cirrhosis were included. Plasma samples of the patients underwent evaluation for hepatitis C virus antibody using the enzyme-linked immunosorbent assay method. Plasma samples and paraffin-embedded liver tissue samples were tested for hepatitis C virus RNA using nested reverse transcriptase-polymerase chain reaction. RESULTS Hepatitis C virus RNA was detected in liver tissue sections of 10 patients (7.9%). However, none of the cryptogenic patients had hepatitis C virus RNA or antibody in their plasma samples. None of the patients had hepatitis C or G virus coinfection, but simultaneous detection of hepatitis B and hepatitis C virus was diagnosed in 4 liver tissue samples. CONCLUSIONS A finding of hepatitis C virus RNA in liver tissue samples of transplant recipients presents the historical possibility of occult hepatitis C virus infection as underlying disease in our patients with cryptogenic cirrhosis. Results present an important and determinative role of occult hepatitis C virus infection in the pathogenesis of cryptogenic cirrhosis, which needs further confirmation in additional studies.
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Affiliation(s)
- Ramin Yaghobi
- >From the Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Kahyesh-Esfandiary R, Sadigh ZA, Esghaei M, Bastani MN, Donyavi T, Najafi A, Fakhim A, Bokharaei-Salim F. Detection of HCV genome in peripheral blood mononuclear cells of Iranian seropositive and HCV RNA negative in plasma of patients with beta-thalassemia major: Occult HCV infection. J Med Virol 2018; 91:107-114. [PMID: 30091793 DOI: 10.1002/jmv.25279] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 07/14/2018] [Indexed: 12/24/2022]
Abstract
Beta (β) thalassemia major is a genetic blood disorder with a deficiency in the hemoglobin beta chain, requiring blood transfusion therapy. Multiple blood transfusions increase the risk of transmitting blood-borne infections. The aim of this study is to determine the frequency of hepatitis C virus (HCV) infection in Iranian individuals with β-thalassemia major. A total of 164 patients with β-thalassemia major were recruited for this study. HCV RNA testing was done on plasma and peripheral blood mononuclear cells (PBMCs) from the HCV seropositive samples (with reverse transcriptase-nested polymerase chain reaction [PCR] method using primers from the 5'-untranslated region [UTR]), and all HCV RNA positive samples were genotyped by the restriction fragment length polymorphism assay. For confirmation of the HCV genotyping in PBMCs of occult HCV infection [OCI]-positive patients, the PCR products of two different regions of HCV (5'-UTR and nonstructural protein 5B [NS5B]) were sequenced. Of 164 patients, 29.3% were positive for anti-HCV antibodies, and HCV RNA was detected in the plasma specimens of 13.4% patients and in the PBMC samples of 15.2% participants. The genomic HCV-RNA was detected in PBMC samples in 3 (6.3%) of the total 48 individuals who were HCV seropositive, and plasma HCV-RNA negative (occult HCV infection). The subtypes of HCV in the plasma and PBMC samples of three participants were not identical. This study shows that among this group of Iranian patients with β-thalassemia major, 13.4% had active HCV infection and 6.3% had occult HCV infection as evidenced by HCV RNA detected in PBMC specimens. Therefore, the design of a prospective study that focuses on the diagnosis of OCI can be very valuable and provide more information.
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Affiliation(s)
| | - Zohreh-Azita Sadigh
- Human Viral Vaccine Department, Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Maryam Esghaei
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Navid Bastani
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Tahereh Donyavi
- HIV Laboratory of National Center, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Najafi
- HIV Laboratory of National Center, Iran University of Medical Sciences, Tehran, Iran
| | - Atousa Fakhim
- Faculty of Engineering, Islamic Azad University, South Tehran Branch, Tehran, Iran
| | - Farah Bokharaei-Salim
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,HIV Laboratory of National Center, Iran University of Medical Sciences, Tehran, Iran
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23
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Occult hepatitis C virus infection among haemodialysis patients. Arab J Gastroenterol 2018; 19:101-105. [PMID: 30245116 DOI: 10.1016/j.ajg.2018.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 03/23/2018] [Accepted: 09/02/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND STUDY AIMS Hepatitis C virus (HCV) infection is a severe problem among patients on maintenance haemodialysis who are at particular risk for blood-borne infections because of prolonged vascular access and potential for exposure to contaminated equipment. Occult hepatitis C virus infection (OCI) is defined as the presence of HCV RNA in liver or peripheral blood mononuclear cells (PBMCs) in the absence of detectable HCV antibody or HCV RNA in the serum. In this study, we aimed to investigate the existence of occult hepatitis C virus infection in PBMCs of haemodialysis (HD) patients in one center. Moreover, we tried to link the condition to risk factors associated with HCV infection in those patients. PATIENTS AND METHODS We included 40 patients with renal diseases undergoing regular haemodialysis who were repeatedly anti-HCV negative. HCV RNA detection was tested by Quantitative Real time PCR in serum and PBMCs. RESULTS The results of this study revealed that 23% of our haemodialysis patients have occult hepatitis C virus infection. There was a highly significant increase in ALT levels in patients with OCI versus the negative group. Also, there is a significant increase of history of blood transfusion in patients with occult HCV (p = 0.03) while the duration of haemodialysis showed no statistical significant difference between both groups. The viral load of the occult hepatitis C virus infection subjects ranged from 581to 74,307 copies/ml. CONCLUSION These results highlight the potential risk of hepatitis C virus transmission from patients within haemodialysis units in Egypt. Isolation of patients on dialysis machines depending on the results of hepatitis serological markers is not enough. Testing for hepatitis C virus -RNA in peripheral blood mononuclear cells is more reliable in identifying patients with an OCI when a liver biopsy is not available.
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Abd Alla MDA, El Awady MK, Dawood RM, Elhawary MA, Al-Azhari SS, Galal ASGM. Hepatitis C virus serologic relapse after treatment with direct-acting antivirals is dependent on viral RNA levels in peripheral blood mononuclear cells and the grade of liver cirrhosis. Arch Virol 2018; 163:2765-2774. [PMID: 29971486 DOI: 10.1007/s00705-018-3922-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 06/13/2018] [Indexed: 12/12/2022]
Abstract
The disappearance of hepatitis C virus (HCV) from serum and tissues for 12 weeks after the end of treatment (EOT) with direct-acting antivirals (DAAs) is known as a "sustained virologic response" (SVR) and occurs more frequently in non-cirrhotic patients than in cirrhotic patients. In this study, we evaluated the outcome of HCV treatment with sofosbuvir (SOF) plus ledipasvir (LDV) at both EOT and 12 weeks after EOT in patients with and without hepatic cirrhosis to address the relationship of serologic relapse to persistent infection of PBMCs and the frequency of hepatic encephalopathy and hepatocellular carcinoma (HCC) after treatment. Seventy-five patients with post-HCV liver cirrhosis were assigned to one of three groups (A, B, and C), each of which included 25 patients and corresponded to the patients' Child-Turcotte-Pugh (CTP) classification. All of the patients received a daily dose of SOF (400 mg) plus LDV (90 mg) for 24 weeks and were tested using HCV single-strand reverse transcription (SRT) and PCR analysis of PBMCs at both EOT and 12 weeks after EOT. Fourteen (18.7%) out of 75 patients (all study populations) had intra-PBMC HCV RNA, but only nine of them (64.3%) developed HCV RNA serum relapse (seroconversion) 12 weeks after EOT (P < 0.001). Encephalopathy was significantly higher in group C at EOT and 12 weeks after EOT (P < 0.05). Development of HCC was observed in decompensated patients of group C (2 out of 5 = 40.0%) 12 weeks post-EOT (P = 0.03). In conclusion, detection of HCV RNA within PBMCs at the EOT provides an indication of potential relapse after 12 weeks. Moreover, development of encephalopathy and HCC after HCV eradication by SOF plus LDV therapy is perhaps a future warning for post-treatment hepatic decompensation in cirrhotic patients.
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Affiliation(s)
- Mohamed Darwish Ahmed Abd Alla
- Tropical Medicine Department, Faculty of Medicine, El-Hussein University Hospital, Al-Azhar University, Gouhar Al-Kaed Street, Al-Darasah, Cairo, 11675, Egypt.
| | | | - Reham M Dawood
- Micrbial Biotechnology Department, National Research Center, Dokki, Cairo, 12622, Egypt
| | - Mostafa Abdelaziz Elhawary
- Tropical Medicine Department, Faculty of Medicine, El-Hussein University Hospital, Al-Azhar University, Gouhar Al-Kaed Street, Al-Darasah, Cairo, 11675, Egypt
| | - Shabaan Salah Al-Azhari
- Tropical Medicine Department, Faculty of Medicine, El-Hussein University Hospital, Al-Azhar University, Gouhar Al-Kaed Street, Al-Darasah, Cairo, 11675, Egypt
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25
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Wang X, Wang S, Liu ZH, Qi WQ, Zhang Q, Zhang YG, Sun DR, Xu Y, Wang HG, Li ZX, Cong XL, Zhao P, Zhou CY, Wang JB. Regulatory polymorphism of CXCL10 rs1439490 in seronegative occult hepatitis C virus infection. World J Gastroenterol 2018; 24:2191-2202. [PMID: 29853737 PMCID: PMC5974581 DOI: 10.3748/wjg.v24.i20.2191] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 03/30/2018] [Accepted: 05/11/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To examine the relationship between the single nucleotide polymorphism CXCL10 rs1439490 and seronegative occult hepatitis C virus (HCV) infection (OCI). METHODS One hundred and three cases of seronegative OCI and 155 cases of seropositive chronic HCV infection (CHC) were diagnosed at five Liver Centers in Northeastern China, from 2012 to 2016. CXCL10 rs1439490, rs1440802, and IL-28B rs12979860 were analyzed by sequencing. Serum CXCL10 was measured by ELISA. Intrahepatic CXCL10 was determined by quantitative PCR and immunohistochemical semi-quantitative scoring. Liver necroinflammation and fibrosis were scored according to the METAVIR system. RESULTS CXCL10 rs1439490 G/G was more prevalent in OCI patients (n = 93/103; 90.3%) than in CHC patients (n = 116/155; 74.8%; P = 0.008). OCI patients had lower serum CXCL10 levels than CHC patients (192.91 ± 46.50 pg/mL vs 354.78 ± 102.91 pg/mL, P < 0.0001). Of IL-28B rs12979860 C/C patients, OCI patients with rs1439490 G/G had lower serum and liver levels of CXCL10 and lower levels of liver necroinflammation and fibrosis than non-G/G patients. OCI patients had higher alanine aminotransferase normalization rates after Peg-interferon treatment than CHC patients (P < 0.05) and serum CXCL10 decreased significantly (P < 0.0001). Liver necroinflammation and fibrosis were alleviated in 8 OCI patients after treatment. Multivariate analysis indicated that rs1439490 G/G significantly influenced the occurrence of OCI in HCV infection (OR = 0.31, 95%CI: 0.15-0.66, P = 0.002). CONCLUSION CXCL10 rs1439490 G/G is positively associated with OCI in HCV infection and antiviral outcome.
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Affiliation(s)
- Xu Wang
- Department of Digestive, China-Japan Union Hospital Affiliated to Jilin University, Changchun 130033, Jilin Province, China
| | - Song Wang
- Department of Urology, First Hospital Affiliated to Jilin University, Changchun 130000, Jilin Province, China
| | - Zhen-Hua Liu
- Department of Digestive, China-Japan Union Hospital Affiliated to Jilin University, Changchun 130033, Jilin Province, China
| | - Wen-Qian Qi
- Department of Digestive, China-Japan Union Hospital Affiliated to Jilin University, Changchun 130033, Jilin Province, China
| | - Qian Zhang
- Department of Digestive, China-Japan Union Hospital Affiliated to Jilin University, Changchun 130033, Jilin Province, China
| | - Yong-Gui Zhang
- Department of Digestive, China-Japan Union Hospital Affiliated to Jilin University, Changchun 130033, Jilin Province, China
| | - De-Rong Sun
- Department of Infectious Disease, the Fourth Affiliated University of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
- Department of Digestive, the Second People’s Hospital of Daqing City, Daqing 163461, Heilongjiang Province, China
| | - Yan Xu
- Department of Digestive, China-Japan Union Hospital Affiliated to Jilin University, Changchun 130033, Jilin Province, China
| | - Hong-Guang Wang
- Department of Digestive, People’s Hospital of Jilin City, Changchun 132000, Jilin Province, China
| | - Zhong-Xie Li
- Department of Digestive, People’s Hospital of Hunchun City, Hunchun 133300, Jilin Province, China
| | - Xian-Ling Cong
- Department of Pathology, China-Japan Union Hospital Affiliated to Jilin University, Changchun 130033, Jilin Province, China
| | - Ping Zhao
- Department of Digestive, China-Japan Union Hospital Affiliated to Jilin University, Changchun 130033, Jilin Province, China
| | - Chang-Yu Zhou
- Department of Digestive, China-Japan Union Hospital Affiliated to Jilin University, Changchun 130033, Jilin Province, China
| | - Jiang-Bin Wang
- Department of Digestive, China-Japan Union Hospital Affiliated to Jilin University, Changchun 130033, Jilin Province, China
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26
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Kiely P, Styles C. Anti-HCV immunoblot indeterminate results in blood donors: non-specific reactivity or past exposure to HCV? Vox Sang 2018; 112:542-548. [PMID: 28850195 DOI: 10.1111/vox.12547] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 05/10/2017] [Accepted: 05/25/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVE The significance of anti-HCV immunoblot (IB) indeterminate results can be difficult to determine. We analysed results for blood donors tested on the MP Diagnostics HCV Blot 3.0 IB assay to determine whether indeterminate results representing past exposure to HCV could be distinguished from those due to non-specific reactivity. MATERIALS AND METHODS Results for all donors tested by IB during the study period (July 2010 to December 2013) were included in this study. RESULTS Of 131 donors tested by IB, 34 (26.0%) were negative, 38 (29.0%) were indeterminate, and 59 (45.0%) were positive. There was no significant difference in IB band reactivity strength between indeterminate and positive donors. The PRISM HCV chemiluminescent immunoassay (ChLIA) sample to cut-off (s/co) ratio distribution for the indeterminate donors was significantly higher than for those with biological false reactivity (P = 0·037), but significantly lower than for donors who were IB positive/HCV RNA negative (P < 0·001) or IB not tested/HCV RNA positive (P < 0·001). Of donors available for follow-up, 53.1% of the indeterminate group disclosed a putative risk factor for HCV infection compared to 39.4% (P < 0·001) for the IB-negative group, 76.6% (P = 0·065) for the IB-positive group and 83.4% (P < 0·001) for the HCV RNA-positive group. CONCLUSION The results of this study indicate that PRISM ChLIA s/co ratios >2·00 with IB indeterminate results predict exposure to HCV, particularly in the presence of putative risk factors for HCV infection. These findings may be applied to optimizing counselling of donors with indeterminate HCV results.
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Affiliation(s)
- P Kiely
- Australian Red Cross Blood Service, Melbourne, Vic., Australia
| | - C Styles
- Australian Red Cross Blood Service, Perth, WA, Australia
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Abdelmoemen G, Khodeir SA, Abou-Saif S, Kobtan A, Abd-Elsalam S. Prevalence of occult hepatitis C virus among hemodialysis patients in Tanta university hospitals: a single-center study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:5459-5464. [PMID: 29214477 DOI: 10.1007/s11356-017-0897-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 12/01/2017] [Indexed: 06/07/2023]
Abstract
Occult hepatitis C virus infection (OCI) is a newly defined type of infection by the chronic hepatitis virus (HCV) distinguished by the existence of HCV RNA in liver tissue and/or peripheral blood mononuclear cells (PBMCs) in patients whose plasma are devoid of both positive serology and RNA. Patients on maintenance hemodialysis evince a higher HCV prevalence than the general population due to high nosocomial transmission by the dialysis units. We investigated the prevalence of occult HCV infection in patients attending our university hemodialysis centers for maintenance hemodialysis. Sixty-two CHD patients negative for serum HCV tests were enrolled in the study. PMNCs were tested by real-time PCR for the presence of HCV RNA. For the 62 patients, the average duration since starting dialysis was 32.7 months and the mean (SD) alanine transaminase and aspartate transaminase were 25.74 ± 9.75 and 28.81 ± 11.32 IU/l, respectively. Out of the 62 CHD patients negative for serum anti-HCV and HCV RNA patients, only three (4.84%) were shown to have HCV RNA in their PBMCs implying the diagnosis of OCI; their viral load range was 1.24-4.15 IU/ml. All three OCI-proven patients gave no history of hepatic disease. In this study, we found that patients considered to be free of HCV can have HCV replicating in their PBMCs. This awareness points to the possibility of HCV being transmitted from apparently uninfected persons. A positive HCV RNA detection in PBMCs is dependable in determining OCI among high-risk subjects particularly when a liver biopsy is not an option. HCV transmission can occur through hemodialysis units signaling incorrect application of infection control measures in our Egyptian dialysis units. Additional studies on hemodialysis patients are necessary to realize the true magnitude of OCI among this patient group and to highlight the importance of incorporating HCV viral assays in PBMCs into the diagnostic algorithm.
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Affiliation(s)
- Ghada Abdelmoemen
- Department of Clinical Pathology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | - Sabry Abou-Saif
- Department of Tropical Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Abdelrahman Kobtan
- Department of Tropical Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Sherief Abd-Elsalam
- Department of Tropical Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.
- Tropical Medicine Department, Tanta University Hospital, El Geish Street, Tanta, Gharbia Governorate, Egypt.
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28
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Taherkhani R, Farshadpour F. Global elimination of hepatitis C virus infection: Progresses and the remaining challenges. World J Hepatol 2017; 9:1239-1252. [PMID: 29312527 PMCID: PMC5745585 DOI: 10.4254/wjh.v9.i33.1239] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 09/01/2017] [Accepted: 10/10/2017] [Indexed: 02/06/2023] Open
Abstract
Today, with the introduction of interferon-free direct-acting antivirals and outstanding progresses in the prevention, diagnosis and treatment of hepatitis C virus (HCV) infection, the elimination of HCV infection seems more achievable. A further challenge is continued transmission of HCV infection in high-risk population specially injecting drug users (IDUs) as the major reservoir of HCV infection. Considering the fact that most of these infections remain undiagnosed, unidentified HCV-infected IDUs are potential sources for the rapid spread of HCV in the community. The continuous increase in the number of IDUs along with the rising prevalence of HCV infection among young IDUs is harbinger of a forthcoming public health dilemma, presenting a serious challenge to control transmission of HCV infection. Even the changes in HCV genotype distribution attributed to injecting drug use confirm this issue. These circumstances create a strong demand for timely diagnosis and proper treatment of HCV-infected patients through risk-based screening to mitigate the risk of HCV transmission in the IDUs community and, consequently, in the society. Meanwhile, raising general awareness of HCV infection, diagnosis and treatment through public education should be the core activity of any harm reduction intervention, as the root cause of failure in control of HCV infection has been lack of awareness among young drug takers. In addition, effective prevention, comprehensive screening programs with a specific focus on high-risk population, accessibility to the new anti-HCV treatment regimens and public education should be considered as the top priorities of any health policy decision to eliminate HCV infection.
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Affiliation(s)
- Reza Taherkhani
- the Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr 7514633341, Iran
| | - Fatemeh Farshadpour
- the Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr 7514633341, Iran
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29
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Lin H, Chen X, Zhu S, Mao P, Zhu S, Liu Y, Huang C, Sun J, Zhu J. Prevalence of Occult Hepatitis C Virus Infection among Blood Donors in Jiangsu, China. Intervirology 2017; 59:204-210. [PMID: 28208127 DOI: 10.1159/000455854] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 01/04/2017] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE In 2010, only 1 donor blood sample was found to be anti-hepatitis C virus (HCV) negative and HCV RNA positive, as detected by nucleic acid testing. In occult HCV infection (OCI), HCV RNA is found in peripheral blood mononuclear cells (PBMCs). We investigated the prevalence of OCI among blood donors. METHODS We collected 513 samples from 334 eligible and 179 deferred donors, including 55 anti-HCV-positive, 113 alanine aminotransferase (ALT)-elevated, and 11 hepatitis B virus surface antigen (HBsAg)-positive blood donors. PBMCs were isolated, the 5'-untranslated region of HCV RNA was amplified by reverse transcription nested PCR, and the genotype of the core region was determined. RESULTS No HCV RNA was detected among the eligible samples. Among the deferred donors, 15 (27.2%) had detectable HCV RNA in 55 anti-HCV PBMC specimens. HCV RNA was detected in 1 (9.1%) HBsAg-positive and 9 (8%) ALT-elevated samples. The prevalence of OCI in the blood donors was 2.2% (10/458). HCV genotypes were determined in 10 subjects, indicating that 2 (20.0%) were subtype 2a, 7 (70.0%) were 1b, and 1 (10%) was 6a. CONCLUSIONS This study showed that OCI does exist among Chinese blood donors. However, to determine the epidemiology and outcome of this HCV infection, further follow-up with more participants and patients receiving blood components with OCI is needed.
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Affiliation(s)
- Hong Lin
- Jiangsu Province Blood Center, Nanjing, China
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30
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Seronegative and occult hepatitis C virus infections in patients with hematological disorders. Arch Virol 2016; 162:63-69. [PMID: 27665588 DOI: 10.1007/s00705-016-3049-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Accepted: 09/03/2016] [Indexed: 12/20/2022]
Abstract
Studies of the association between seronegative or occult (OCI) hepatitis C virus (HCV) infection, and hematological disorders have yielded controversial results. The aim of this study was to investigate seronegative and OCI HCV infections in among patients with different hematological disorders. This study included 90 anti-HCV-negative patients with either benign or malignant hematological disorders (group I), along with 20 age- and sex-matched apparently healthy subjects, who served as controls (group II). We tested for HCV RNA in sera and PBMCs by RT-nested PCR and for liver enzyme activity. Seronegativity and OCI were detected in 66.7 % and 20 % respectively, of the studied cases (group I). OCI was more evident in Hodgkin lymphoma and thalassemia. A significant increase in AST activity was observed in the seronegative and OCI groups and in ALT and AST in HCV-seronegative or OCI and negative HCV patients (p ≤ 0.05). Seronegativity and OCI are a significant clinical problem in patients with hematological disorders, warranting wider use of molecular tests combined with periodic evaluations of liver functions for diagnostic purposes.
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31
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Abdelrahim SS, Khairy R, Esmail MAM, Ragab M, Abdel-Hamid M, Abdelwahab SF. Occult hepatitis C virus infection among Egyptian hemodialysis patients. J Med Virol 2016; 88:1388-93. [PMID: 26743014 DOI: 10.1002/jmv.24467] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2016] [Indexed: 02/05/2023]
Abstract
Occult hepatitis C virus (HCV) infection (OCI) was reported in an apparently disease-free state in the absence of liver disease, anti-HCV and HCV-RNA in the serum. The existing data examining the clinical significance of OCI and its potential as a source of HCV infection among hemodialysis patients are very limited. We examined the presence of OCI among patients on maintenance hemodialysis at Minia Governorate, Egypt; an HCV endemic country. A total of 81 subjects with negative markers for HCV were enrolled. HCV-RNA was tested in PBMCs by real-time PCR. For the 81 subjects, the average dialysis duration was 32.7 ± 21.7 months and the average ALT level (±SD) was 26 ± 12 U/L while that of AST was 29 ± 16 U/L. Out of the 81 subjects, three (3.7%) were HCV-RNA positive in PBMCs in the absence of serum anti-HCV and HCV-RNA indicating OCI. The viral load of the OCI subjects ranged from 172 to 4150 IU/ml. History of liver disease was positive in one of the three positive patients. These results highlight the potential risk of HCV transmission from patients within hemodialysis units in Egypt. J. Med. Virol. 88:1388-1393, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Soha S Abdelrahim
- Department of Microbiology and Immunology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Rasha Khairy
- Department of Microbiology and Immunology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Mona Abdel-Monem Esmail
- Department of Microbiology and Immunology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Mahmoud Ragab
- Department of Internal Medicine, Faculty of Medicine, Minia University, Minia, Egypt
| | - Mohamed Abdel-Hamid
- Department of Microbiology and Immunology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Sayed F Abdelwahab
- Department of Microbiology and Immunology, Faculty of Medicine, Minia University, Minia, Egypt
- Department of Microbiology, Taif Faculty of Pharmacy, Al-Haweiah, Taif, Kingdom of Saudi Arabia
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Roque Cuéllar MC, García-Lozano JR, Sánchez B, Praena-Fernández JM, Martínez Sierra C, Núñez-Roldán A, Aguilar-Reina J. Lymphomagenesis-related gene expression in B cells from sustained virological responders with occult hepatitis C virus infection. J Viral Hepat 2016; 23:606-13. [PMID: 26946048 DOI: 10.1111/jvh.12526] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 01/16/2016] [Indexed: 12/14/2022]
Abstract
The expression of activation-induced cytidine deaminase, B-aggressive lymphoma, cyclin D1 and serine/threonine kinase 15 genes, among others, is increased in B cells from patients with chronic hepatitis C virus (HCV) infection. It is unknown whether the level of expression of these genes in B cells is increased in patients with hepatitis C who have achieved a sustained virological response (SVR) but who have persistent, detectable HCV RNA, so-called occult infection. Eighty-three patients who achieved and SVR, 27 with detectable HCV and 56 without detectable HCV RNA, 28 chronic hepatitis C patients and 32 healthy controls were studied. RNA was extracted from B cells, and gene expression levels were measured by RT-PCR. Patients with chronic HCV and those who achieved an SVR (with and without persistent low-level HCV RNA) showed a statistically significant higher expression compared to healthy controls, of activation-induced cytidine deaminase (P = 0.004, P < 0.001 and P = 0.002, respectively), B-aggressive lymphoma (P < 0.001, P = 0.001 and P = 0.006) and cyclin D1 (P = 0.026, P = 0.001; P = 0.038). For activation-induced cytidine deaminase patients with an SVR and 'occult infection' had a statistically significantly higher expression level than patients with and SVR without 'occult infection' (P = 0.014). The higher expression levels found for activation-induced cytidine deaminase, together with other genes indicates that these B lymphomagenesis-related genes are upregulated following HCV therapy and this is more marked when HCV can be detected in PBMCs.
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Affiliation(s)
- M C Roque Cuéllar
- Biomedicine Institute of Seville (IBIS), University Hospital Virgen del Rocio, CSIC, University of Seville, Seville, Spain
| | - J R García-Lozano
- Department of Immunology, IBIS, University Hospital Virgen del Rocio, CSIC, University of Seville, Seville, Spain
| | - B Sánchez
- Department of Immunology, IBIS, University Hospital Virgen del Rocio, CSIC, University of Seville, Seville, Spain
| | - J M Praena-Fernández
- Statistics, Methodology and Research Evaluation Unit, Andalusian Public Foundation for Health Research Management in Seville (FISEVI), IBIS, University Hospital Virgen del Rocio, CSIC, University of Seville, Seville, Spain
| | - C Martínez Sierra
- Department of Gastroenterology, University Hospital Virgen del Rocio, Seville, Spain
| | - A Núñez-Roldán
- Department of Immunology, IBIS, University Hospital Virgen del Rocio, CSIC, University of Seville, Seville, Spain
| | - J Aguilar-Reina
- Biomedicine Institute of Seville (IBIS), University Hospital Virgen del Rocio, CSIC, University of Seville, Seville, Spain
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Bastani MN, Bokharaei-Salim F, Keyvani H, Esghaei M, Monavari SH, Ebrahimi M, Garshasebi S, Fakhim S. Prevalence of occult hepatitis C virus infection in Iranian patients with beta thalassemia major. Arch Virol 2016; 161:1899-906. [PMID: 27132015 DOI: 10.1007/s00705-016-2862-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 04/06/2016] [Indexed: 12/15/2022]
Abstract
Occult hepatitis C virus infection (OCI) is a new pathological form of chronic hepatitis virus (HCV) infection characterized by the presence of HCV RNA in liver biopsy and/or peripheral blood mononuclear cell (PBMC) specimens and the absence of HCV RNA and anti-HCV antibodies (Abs) in plasma samples. β-thalassemia major is a hereditary recessive blood disease with deficiency in the hemoglobin beta chain. Thalassemic patients need blood transfusion therapy; repeated blood transfusion increases the risk of viral blood-borne infection. The aim of this study was to determine the prevalence of OCI in Iranian patients with β-thalassemia major. From February 2015 to November 2015, a total of 147 Iranian patients with β-thalassemia major were enrolled in this cross-sectional study. After extraction of viral RNA from the plasma and PBMC samples, HCV genomic RNA in the specimens was amplified by RT-nested PCR using primers from the 5'-UTR. The HCV genotypes of the positive specimens were tested using the RFLP assay. To confirm the HCV genotypes, the 5'-UTR fragment was amplified and cloned into the pJET1.2/blunt cloning vector and then sequenced. Out of 147 patients, 106 (72.1 %) were negative for anti-HCV Abs and HCV RNA. HCV RNA was found in PBMC specimens of six (5.7 %) patients, from a total of 106 patients with undetectable plasma HCV RNA and anti-HCV Abs. Therefore, six out of 106 patients had OCI. HCV genotyping revealed that three patients were infected with HCV subtype 1b, two patients were infected with HCV subtype 3a, and one patient was infected with HCV subtype 1a. These results revealed that Iranian patients with beta-thalassemia major might have OCI. Therefore, it seems that the design of a study to identify this infection in patients with β-thalassemia major would provide valuable information.
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Affiliation(s)
- Mohammad-Navid Bastani
- Department of Virology, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Farah Bokharaei-Salim
- Department of Virology, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran. .,HIV Laboratory of National Center, Deputy of Health, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran.
| | - Hossein Keyvani
- Department of Virology, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Maryam Esghaei
- Department of Virology, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | | | - Mojtaba Ebrahimi
- Iranian Blood Transfusion Organization (IBTO), Thalassemia Center, Tehran, Islamic Republic of Iran
| | - Saba Garshasebi
- HIV Laboratory of National Center, Deputy of Health, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Shahin Fakhim
- Department of Civil Engineering, Faculty of Engineering, Payame Noor University, Karaj, Islamic Republic of Iran
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Attar BM, Van Thiel DH. Hepatitis C virus: A time for decisions. Who should be treated and when? World J Gastrointest Pharmacol Ther 2016; 7:33-40. [PMID: 26855810 PMCID: PMC4734952 DOI: 10.4292/wjgpt.v7.i1.33] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 09/09/2015] [Accepted: 11/17/2015] [Indexed: 02/06/2023] Open
Abstract
Cirrhosis is the most important risk factor for hepatocellular carcinoma (HCC) regardless of the etiology of cirrhosis. Compared to individuals who are anti-hepatitis C virus (HCV) seronegative, anti-HCV seropositive individuals have a greater mortality from both hepatic as well as nonhepatic disease processes. The aim of this paper is do describe the burden of HCV infection and consider treatment strategies to reduce HCV-related morbidity and mortality. The newly developed direct acting antiviral (DAA) therapies are associated with greater rates of drug compliance, fewer adverse effects, and appear not to be limited by the presence of a variety of factors that adversely affect the outcome of interferon-based therapies. Because of the cost of the current DAA, their use has been severely rationed by insurers as well as state and federal agencies to those with advanced fibrotic liver disease (Metavir fibrosis stage F3-F4). The rationale for such rationing is that many of those recognized as having the disease progress slowly over many years and will not develop advanced liver disease manifested as chronic hepatitis C, cirrhosis, and experience any of the multiple complications of liver disease to include HCC. This mitigation has a short sided view of the cost of treatment of hepatitis C related disease processes and ignores the long-term expenses of hepatitis C treatment consisting of the cost of treatment of hepatitis C, the management of cirrhosis with or without decompensation as well as the cost of treatment of HCC and liver transplantation. We believe that treatment should include all HCV infected patients including those with stage F0-F2 fibrosis with or without evidence of coexisting liver disease. Specifically, interferon (IFN)-free regimens with the current effective DAAs without liver staging requirements and including those without evidence of hepatic diseases but having recognized extrahepatic manifestations of HCV infection is projected to be the most cost-effective approach for treating HCV in all of its varied presentations. Early rather than later therapy of HCV infected individuals would be even more efficacious than waiting particularly if it includes all cases from F0-F4 hepatic disease. Timely therapy will reduce the number of individuals developing advanced liver disease, reduce the cost of treating these cases and more importantly, reduce the lifetime cost of treatment of those with any form of HCV related disease as well as HCV associated all - cause mortality. Importantly, HCV treatment regimens without any restrictions would result in a substantial reduction in health care expenditure and simultaneously reduce the number of infected individuals who are infecting others.
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El-Shishtawy S, Sherif N, Abdallh E, Kamel L, Shemis M, Saleem AAA, Abdalla H, El Din HG. Occult Hepatitis C Virus Infection in Hemodialysis Patients; Single Center Study. Electron Physician 2015; 7:1619-25. [PMID: 26816589 PMCID: PMC4725416 DOI: 10.19082/1619] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 10/09/2015] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION A new form of hepatitis C virus infection, known as occult hepatitis C virus (HCV) infection, is characterized by the presence of HCV_RNA in the liver or peripheral blood mononuclear cells (PBMCs). However, no serological markers of infection occur and there is not as much damage to the liver damage as is produced by chronic hepatitis C. There is a high incidence of HCV infection among hemodialysis patients, there is significant concern about viral transmission. HCV infection is a major problem in hemodialysis (HD) units even though blood products are screened for anti-HCV antibodies and other precautions are taken. The aim of this study was to determine the prevalence of occult HCV infection in PBMC in chronic hemodialysis (CHD) patients in the dialysis unit at Theodor Bilharz Research Institute (TBRI) with HCV antibodies and HCV RNA negativity irrespective of their liver function tests. METHODS Fifty-three patients who were repeatedly were anti-HCV negative and serum HCV-RNA negative and on regular hemodialysis for > six months were enrolled in the study, which was conducted in the dialysis unit of Nephrology Department at TBRI; there were 10 healthy matched controls. The patients were classified into two groups according to the result HCV RNA in their PBMCs. Serological markers of HCV infection, including anti-HCV antibody and serum HCV-RNA, were repeatedly negative for all patients included in the study. We collected serum and PBMC samples from the patients on the day they entered the study. The test of all serum samples for anti-HCV antibodies and HCV-RNA was repeated by RT-PCR to ensure that the patients did not have these HCV serologic markers, We also measured their ALT and GGT levels. RESULTS Occult hepatitis C virus infection (OCI) was detected in 15.1% of our CHD patients without any evidence of chronic liver disease. CONCLUSION Occult HCV infection was present among the hemodialysis patients irrespective of whether they had persistent abnormal values of liver enzymes for which no cause had been identified. Further study is required to determine the clinical significance of occult HCV infections in these patients.
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Affiliation(s)
| | - Nevine Sherif
- Nephrology Department, Theodor Bilharz Research Institute, Giza, Egypt
| | - Emad Abdallh
- Nephrology Department, Theodor Bilharz Research Institute, Giza, Egypt
| | - Laila Kamel
- Clinical Pathology Department Theodor Bilharz Research Institute, Giza, Egypt
| | - Mohamed Shemis
- Biochemistry Department, Theodor Bilharz Research Institute, Giza, Egypt
| | | | - Haitham Abdalla
- Department of Tropical Diseases, Theodor Bilharz Research Institute, Giza, Egypt
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Rezaee-Zavareh MS, Hadi R, Karimi-Sari H, Hossein Khosravi M, Ajudani R, Dolatimehr F, Ramezani-Binabaj M, Miri SM, Alavian SM. Occult HCV Infection: The Current State of Knowledge. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 17:e34181. [PMID: 26734487 PMCID: PMC4698335 DOI: 10.5812/ircmj.34181] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 11/02/2015] [Indexed: 12/12/2022]
Abstract
Context Occult HCV infection (OCI) is defined as the presence of HCV-RNA in hepatocytes and the absence of HCV in the serum according to usual tests. We aimed to define OCI and provide information about the currently available diagnostic methods. Then we focus on specific groups that are at high risk of OCI and finally investigate immune responses to OCI and the available treatment approaches. Evidence Acquisition PubMed, Scopus and Google Scholar were comprehensively searched with combination of following keywords: “occult”, “hepatitis C virus” and “occult HCV infection”. The definition of OCI, diagnostic methods, specific groups that are at high risk and available treatment approaches were extract from literature. An analysis of available articles on OCI also was done based on Scopus search results. Results OCI has been reported in several high-risk groups, especially in hemodialysis patients and subjects with cryptogenic liver disease. Furthermore, some studies have proposed a specific immune response for OCI in comparison with chronic hepatitis C (CHC). Conclusions With a clinical history of approximately 11 years, occult HCV infection can be considered an occult type of CHC. Evidences suggest that considering OCI in these high-risk groups seems to be necessary. We suggest that alternative diagnostic tests should be applied and that there is a need for the participation of all countries to determine the epidemiology of this type of HCV infection. Additionally, evaluating OCI in blood transfusion centers and in patients who receive large amounts of blood and clotting factors, such as patients with hemophilia, should be performed in future projects.
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Affiliation(s)
- Mohammad Saeid Rezaee-Zavareh
- Students’ Research Committee, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Middle East Liver Diseases Center (MELD), Tehran, IR Iran
| | - Reza Hadi
- Middle East Liver Diseases Center (MELD), Tehran, IR Iran
| | - Hamidreza Karimi-Sari
- Students’ Research Committee, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | | | - Reza Ajudani
- Students’ Research Committee, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Fardin Dolatimehr
- Students’ Research Committee, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Mahdi Ramezani-Binabaj
- Students’ Research Committee, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Seyyed Mohammad Miri
- Middle East Liver Diseases Center (MELD), Tehran, IR Iran
- Kowsar Medical Institute, Heerlen, The Netherlands
| | - Seyed Moayed Alavian
- Middle East Liver Diseases Center (MELD), Tehran, IR Iran
- Baqiyatallah Research Center for Gasteroenterology and Liver Disease (BRCGL), Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Seyed Moayed Alavian, Middle East Liver Diseases Center, Tehran, IR Iran. Tel: +98-2188945186, Fax: +98-2188945188, E-mail:
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Rezaee Zavareh MS, Alavian SM. Occult Hepatitis C Infection Should Be More Noticed With New Treatment Strategies. HEPATITIS MONTHLY 2015; 15:e33462. [PMID: 26834794 PMCID: PMC4717287 DOI: 10.5812/hepatmon.33462] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 10/04/2015] [Indexed: 02/07/2023]
Affiliation(s)
- Mohammad Saeid Rezaee Zavareh
- Students’ Research Committee, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Middle East Liver Diseases Center, Tehran, IR Iran
| | - Seyed Moayed Alavian
- Middle East Liver Diseases Center, Tehran, IR Iran
- Baqiyatallah Research Center for Gasteroenterology and Liver Disease (BRCGL), Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Seyed Moayed Alavian, Middle East Liver Diseases Center, Tehran, IR Iran. Tel: +98-2188945186, Fax: +98-2188945188, E-mail:
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Taherkhani R, Farshadpour F. Epidemiology of hepatitis C virus in Iran. World J Gastroenterol 2015; 21:10790-810. [PMID: 26478671 PMCID: PMC4600581 DOI: 10.3748/wjg.v21.i38.10790] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 05/20/2015] [Accepted: 08/31/2015] [Indexed: 02/06/2023] Open
Abstract
In Iran, the prevalence of hepatitis C virus (HCV) infection is relatively low according to the population-based epidemiological studies. However, the epidemiology of HCV is changing and the rate of HCV infection is increasing due to the growth in the number of injecting drug users in the society. In addition, a shift has occurred in the distribution pattern of HCV genotypes among HCV-infected patients in Iran. Genotype 1a is the most prevalent genotype in Iran, but in recent years, an increase in the frequency of 3a and a decrease in 1a and 1b have been reported. These variations in the epidemiology of HCV reflect differences in the routes of transmission, status of public health, lifestyles, and risk factors in different groups and geographic regions of Iran. Health policy makers should consider these differences to establish better strategies for control and prevention of HCV infection. Therefore, this review was conducted to present a clear view regarding the current epidemiology of HCV infection in Iran.
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Kaźmierczak J, Caraballo Cortes K, Bukowska-Ośko I, Radkowski M. Virus-Specific Cellular Response in Hepatitis C Virus Infection. Arch Immunol Ther Exp (Warsz) 2015; 64:101-10. [PMID: 26429740 DOI: 10.1007/s00005-015-0364-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 06/08/2015] [Indexed: 12/15/2022]
Abstract
Studies performed on chimpanzees and humans have revealed that strong, multispecific and sustained CD4(+) and CD8(+) T cell immune responses is a major determinant of hepatitis C virus (HCV) clearance. However, spontaneous elimination of the virus occurs in minority of infected individuals and cellular response directed against HCV antigens is not persistent in individuals with chronic infection. This review presents characteristics of the HCV-specific T cell response in patients with different clinical course of infection, including acute and chronic infection, persons who spontaneously eliminated HCV and non-infected subjects exposed to HCV. Detection of HCV-specific response, especially in non-infected subjects exposed to HCV, may be indicative of HCV prevalence in population and rate of spontaneous viral clearance. Understanding the mechanisms and role of HCV-specific cellular immune response would contribute to better understanding of HCV epidemiology, immunopathogenesis and may help to design an effective vaccine.
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Affiliation(s)
- Justyna Kaźmierczak
- Department of Immunopathology of Infectious and Parasitic Diseases, Medical University of Warsaw, Pawińskiego 3c, 02-106, Warsaw, Poland.
| | - Kamila Caraballo Cortes
- Department of Immunopathology of Infectious and Parasitic Diseases, Medical University of Warsaw, Pawińskiego 3c, 02-106, Warsaw, Poland
| | - Iwona Bukowska-Ośko
- Department of Immunopathology of Infectious and Parasitic Diseases, Medical University of Warsaw, Pawińskiego 3c, 02-106, Warsaw, Poland
| | - Marek Radkowski
- Department of Immunopathology of Infectious and Parasitic Diseases, Medical University of Warsaw, Pawińskiego 3c, 02-106, Warsaw, Poland
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Eslamifar A, Ramezani A, Ehteram H, Razeghi E, Ahmadi F, Amini M, Banifazl M, Etemadi G, Keyvani H, Bavand A, Aghakhani A. Occult hepatitis C virus infection in Iranian hemodialysis patients. J Nephropathol 2015; 4:116-20. [PMID: 26457258 PMCID: PMC4596295 DOI: 10.12860/jnp.2015.22] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 06/13/2015] [Indexed: 12/18/2022] Open
Abstract
Background: Occult hepatitis C virus (HCV) infection is defined as the presence of HCV-RNA in liver or peripheral blood mononuclear cells (PBMCs) in the absence of detectable hepatitis C antibody (anti-HCV) or HCV-RNA in the serum. Low concentrations of HCV-RNA may be detected in PBMCs of hemodialysis (HD) patients and this could have a great impact on the management of HD patients.
Objectives: The aim of this study was to detect the occult HCV infection in Iranian HD patients.
Patients and Methods: A total of 70 anti-HCV negative HD patients from three dialysis units in Tehran, Iran were included in this study. In these cases, presence of HCV-RNA in plasma samples was tested by reverse transcriptase-nested polymerase chain reaction (RT-nested PCR). In cases with negative anti-HCV and plasma HCV-RNA, genomic HCV-RNA was checked in PBMC specimens by RT-nested PCR.
Results: Seventy anti-HCV negative HD patients were enrolled in the study. 32.85% and 1.43% of cases had elevated levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) respectively. 7.14% of patients had elevated levels of both ALT and AST. HCV-RNA was negative in plasma samples of all anti-HCV negative HD subjects. The genomic HCV-RNA was not detected in any PBMC samples of HD cases with negative anti-HCV and plasma HCV-RNA.
Conclusions: Occult HCV infection was not detected in our HD patients despite of elevated levels of liver enzymes in some participants. Further studies involving larger number of HD patients are required to elucidate the rate of occult HCV infection in HD cases.
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Affiliation(s)
- Ali Eslamifar
- Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran
| | - Amitis Ramezani
- Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran
| | - Hassan Ehteram
- Department of Pathology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Effat Razeghi
- Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farrokhlagha Ahmadi
- Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Manouchehr Amini
- Nephrology Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Banifazl
- Iranian Society for Support of Patients with Infectious Diseases, Tehran, Iran
| | | | - Hossein Keyvani
- Department of Virology, Iran University of Medical Sciences, Tehran, Iran
| | - Anahita Bavand
- Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran
| | - Arezoo Aghakhani
- Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran
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Rezaee-Zavareh MS, Ramezani-Binabaj M, Moayed Alavian S. Screening for occult hepatitis C virus infection: Does it need special attention? Hepatology 2015; 62:321-2. [PMID: 25476196 DOI: 10.1002/hep.27626] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Mohammad Saeid Rezaee-Zavareh
- Students' Research Committee, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Middle East Liver Diseases Center, Tehran, Iran
| | - Mahdi Ramezani-Binabaj
- Students' Research Committee, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Middle East Liver Diseases Center, Tehran, Iran
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Attar BM, Van Thiel D. A New Twist to a Chronic HCV Infection: Occult Hepatitis C. Gastroenterol Res Pract 2015; 2015:579147. [PMID: 26221136 PMCID: PMC4495183 DOI: 10.1155/2015/579147] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Revised: 04/15/2015] [Accepted: 05/24/2015] [Indexed: 02/07/2023] Open
Abstract
Background. The prevalence of occult hepatitis C infection (OCI) in the population of HCV-RNA negative but anti-HCV positive individuals is presently unknown. OCI may be responsible for clinically overt recurrent disease following an apparent sustained viral response (SVR) weeks to years later. Purpose. To review the available current literature regarding OCI, prevalence, pathogenic mechanisms, clinical characteristics, and future directions. Data Sources. Searching MEDLINE, article references, and national and international meeting abstracts for the diagnosis of OCI (1990-2014). Data Synthesis. The long-term followup of individuals with an OCI suggests that the infection can be transient with the loss of detectable HCV-RNA in PPBMCs after 12-18 months or alternatively exist intermittently and potentially long term. The ultimate outcome of HCV infection is decided by interplay between host immune responses, antiviral therapies, and the various well-identified viral evasion mechanisms as well as the presence of HCV infection within extrahepatic tissues. Conclusion. The currently widely held assumption of a HCV-cure in individuals having had "SVR" after 8-12 weeks of a course of DAA therapy as recently defined may not be entirely valid. Careful longitudinal followup utilizing highly sensitive assays and unique approaches to viral isolation are needed.
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Affiliation(s)
- Bashar M. Attar
- Division of Gastroenterology and Hepatology, Cook County Health and Hospitals System, 1901 West Harrison Street, Chicago, IL 60612, USA
- Rush University Medical Center, Chicago, IL 60612, USA
| | - David Van Thiel
- Advanced Liver and Gastrointestinal Disease Center, Berwyn, IL 60402, USA
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Kuroishi A, Yasui K, Matsukura H, Tani Y, Furuta RA. Comparison of neutralization profiles for anti-HCV reactive donor samples with or without detectable HCV RNA. Vox Sang 2015; 109:319-26. [PMID: 26095725 DOI: 10.1111/vox.12301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 04/23/2015] [Accepted: 04/23/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES At Japanese Red Cross (JRC) Blood Centers, all donated blood is screened for hepatitis C virus (HCV) by serological and nucleic acid amplification testing. Donor plasma that tested reactive for anti-HCV by serological test is disqualified even if the donor tests negative for HCV RNA. These test results reflect both true-positive results because of past HCV infection and false-positive results because the cross-reactivity of plasma IgG, which current testing methods are unable to distinguish. To characterize these antibody test results, we examined the neutralizing activity of these plasma samples. MATERIAL AND METHODS Donor plasma samples that tested reactive for anti-HCV by serological test but negative for HCV RNA (n = 43) were analysed for determining their neutralizing activities measured by the inhibition of the cellular entry of pseudoparticles harbouring HCV envelope glycoproteins (HCVpp). RESULTS Strong and broad neutralizing activities against HCVpp entry similar to the samples that tested reactive for anti-HCV serological test and positive for HCV RNA (considered to be derived from individuals with chronic HCV infection) were observed in three of 43 plasma samples from donors who tested anti-HCV reactive but HCV RNA negative. CONCLUSION By examining the neutralizing activities of plasma samples, we identified individuals with a past HCV infection from those in whom we were unable to confirm HCV infection according to the current testing algorithms of JRC, which do not perform anti-HCV confirmatory tests.
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Affiliation(s)
- A Kuroishi
- Japanese Red Cross Kinki Block Blood Center, Osaka, Japan
| | - K Yasui
- Japanese Red Cross Kinki Block Blood Center, Osaka, Japan
| | - H Matsukura
- Japanese Red Cross Kinki Block Blood Center, Osaka, Japan
| | - Y Tani
- Japanese Red Cross Kinki Block Blood Center, Osaka, Japan
| | - R A Furuta
- Japanese Red Cross Kinki Block Blood Center, Osaka, Japan
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44
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Kiely P. Screening blood donors for hepatitis C virus: the challenge to consider cost-effectiveness. Transfusion 2015; 55:1143-6. [PMID: 26074174 DOI: 10.1111/trf.13127] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 03/17/2015] [Indexed: 01/18/2023]
Affiliation(s)
- Philip Kiely
- Australian Red Cross Blood Service, Melbourne, Australia
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Fazlalipour M, Keyvani H, Monavari SHR, Mollaie HR. Expression, Purification and Immunogenic Description of a Hepatitis C Virus Recombinant CoreE1E2 Protein Expressed by Yeast Pichia pastoris. Jundishapur J Microbiol 2015; 8:e17157. [PMID: 26034544 PMCID: PMC4449863 DOI: 10.5812/jjm.8(4)2015.17157] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2013] [Revised: 05/14/2014] [Accepted: 07/26/2014] [Indexed: 01/26/2023] Open
Abstract
Background: Gradual development of a useful vaccine can be the main point in the control and eradication of Hepatitis C virus (HCV) infection. Hepatitis C Virus envelope glycoproteins are considered as the main HCV vaccine candidate. Objectives: In this study, the Pichia pastoris expression system was used to express a recombinant HCV CoreE1E2 protein, which consists of Core (269 nt-841nt) E1 (842 nt-1417nt) and E2 (1418 nt-2506nt). Materials and Methods: By a codon optimization technique based on the P. pastoris expression system, we could increase the rate of recombinant proteins. Moreover, the purified protein can efficiently induce anti-CoreE1E2 antibodies in rabbits, and also by developing a homemade Enzyme-Linked ELISA kit we can detect antibody of HCV Iranian patients with genotype 1a. Results: In our study, the virus-like particle of rCoreE1E2 with 70 nm size, was shown by Electron microscopy and proved the self-assembly in vitro in a yeast expression system. Conclusions: These findings of the present study indicate that the recombinant CoreE1E2 glycoprotein is effective in inducing neutralizing antibodies, and is an influential HCV vaccine candidate.
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Affiliation(s)
- Mehdi Fazlalipour
- Department of Medical Virology, Iran University of Medical Sciences, Tehran, IR Iran
| | - Hossein Keyvani
- Department of Medical Virology, Iran University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Hossein Keyvani, Department of Medical Virology, Iran University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-9126222938, E-mail:
| | | | - Hamid Reza Mollaie
- Department of Medical Virology, Iran University of Medical Sciences, Tehran, IR Iran
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El Shazly Y, Hemida K, Rafik M, Al Swaff R, Ali-Eldin ZA, GadAllah S. Detection of occult hepatitis C virus among healthy spouses of patients with HCV infection. J Med Virol 2014; 87:424-7. [PMID: 25185940 DOI: 10.1002/jmv.24074] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2014] [Indexed: 01/29/2023]
Abstract
The criterion standard for the diagnosis of occult hepatitis C virus (HCV) infection is detection of HCV-RNA in liver cells. However, because of the invasive nature of liver biopsy, other methods have been studied. The present study aimed to identify subjects with occult HCV-4 infection among healthy sexual partners of patients with chronic HCV-4 infection by detecting HCV-RNA in peripheral blood mononuclear cells (PBMCs) using real-time polymerase chain reaction (PCR). Fifty healthy Egyptian spouses of patients with chronic HCV-4 infection were included in this study. Real-time PCR was used to detect HCV-RNA in PBMCs in all the study subjects. The prevalence of occult HCV-4 infection was 4%, and a statistically significant higher prevalence was found among patients with a history of sexually transmitted infection. The results of the present study indicate the importance of intra-spousal transmission of HCV-4 infection, especially in subjects with a history of sexually transmitted infection.
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Affiliation(s)
- Yahia El Shazly
- Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Rezaee Zavareh MS, Alavian SM, Karimisari H, Shafiei M, Saiedi Hosseini SY. Occult hepatitis C virus infection in patients with autoimmune hepatitis. HEPATITIS MONTHLY 2014; 14:e16089. [PMID: 25337141 PMCID: PMC4199148 DOI: 10.5812/hepatmon.16089] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Revised: 12/27/2013] [Accepted: 02/24/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Occult hepatitis C virus infection (OCI) is recognized by finding hepatitis C virus (HCV) RNA in hepatocytes without detectable anti-HCV antibodies and viral RNA in plasma. Autoimmune hepatitis (AIH) is a chronic and generally progressive disease without exactly-identified etiology. OBJECTIVES This study aimed to determine the prevalence of OCI among patients with AIH and to evaluate the tests used to rule out HCV infection in diagnosing AIH. PATIENTS AND METHODS Between July 2012 to February 2013, 35 Iranian patients with AIH who attended Tehran Hepatitis Center were investigated. For identifying OCI, detection of HCV RNA in both ultracentrifuged serum samples and peripheral blood mononuclear cells (PBMCs) was used. Data analysis was performed using SPSS. RESULTS Six males and 29 females with mean disease duration of 77.1 ± 39.5 month and mean age of 43.62 ± 12.67 years were investigated. All cases were negative for anti-HCV antibody and we could not find any HCV RNA in ultracentrifuged serum samples and PBMCs. CONCLUSIONS With our laboratory diagnostic method, it seems that there are no cases of OCI in patients with AIH. However, we recommend further studies with more samples and more precise laboratory method.
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Affiliation(s)
- Mohammad Saeid Rezaee Zavareh
- Students' Research Committee, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Middle East Liver Diseases Center (MELD), Tehran, IR Iran
| | - Seyed Moayed Alavian
- Middle East Liver Diseases Center (MELD), Tehran, IR Iran
- Corresponding Author: Seyed Moayed Alavian, Middle East Liver Diseases Center (MELD), Tehran, IR Iran. Tel: +98-2188945186, Fax: +98-2188945188, E-mail:
| | - Hamidreza Karimisari
- Students' Research Committee, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
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Garazzino S, Calitri C, Versace A, Alfarano A, Scolfaro C, Bertaina C, Vatrano S, Mignone F, Licciardi F, Gabiano C, Tovo PA. Natural history of vertically acquired HCV infection and associated autoimmune phenomena. Eur J Pediatr 2014; 173:1025-31. [PMID: 24585099 DOI: 10.1007/s00431-014-2286-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Revised: 02/10/2014] [Accepted: 02/16/2014] [Indexed: 12/17/2022]
Abstract
UNLABELLED The natural history of vertically acquired HCV infection is ill defined. The aim of this study was to outline the natural course of vertical HCV infection in a cohort of untreated children, including rate of spontaneous viral clearance, frequency and features of HCV-related autoimmune disorders. Children with vertical HCV infection were prospectively followed from the first month of life with regular clinical and laboratory assessments. Statistical analysis was performed using Prism 5.0. Forty-five children (median age 12 years, interquartile range 6.9-15.5) were studied. Genotype 1 was predominant (53.3 %). Spontaneous viral clearance was achieved by 12 patients (26.7 %) and associated with genotype 3. Alanine-amino-transferase levels were increased in most children in the first 2 years of life with higher values in those who later cleared the infection. All children were asymptomatic for liver disease. Transient elastography (32 patients) showed mild or moderate fibrosis in nine and two cases, respectively. Non-organ-specific autoantibodies were detected in 24 children (53.3 %) independently of viremia; of these, one developed type-1 diabetes. Cryoglobulinemia was associated with genotype 1 infection and found in 15 subjects (33.3 %): two had low C4 levels and persistent proteinuria. CONCLUSIONS Vertically acquired HCV infection may result in spontaneous clearance in up to 27 % of children. Resolution of infection is higher with genotype 3, usually occurs in preschool age and persists over time. Chronic infection is generally asymptomatic, although hepatomegaly and mild fibrosis may develop. Autoantibodies and cryoglobulins are frequent, whereas the associated clinical manifestations are rare.
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Affiliation(s)
- Silvia Garazzino
- Department of Pediatrics, University of Turin, Regina Margherita Children's Hospital, Turin, Italy,
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Rezaee-Zavareh MS, Einollahi B. Treatment of occult hepatitis C virus infection: does it need special attention? HEPATITIS MONTHLY 2014; 14:e16665. [PMID: 25067939 PMCID: PMC4101422 DOI: 10.5812/hepatmon.16665] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Accepted: 12/30/2013] [Indexed: 12/11/2022]
Affiliation(s)
- Mohammad Saeid Rezaee-Zavareh
- Students’ Research Committee, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Middle East Liver Diseases Center (MELD), Tehran, IR Iran
- Corresponding Author: Mohammad Saeid Rezaee-Zavareh, Students’ Research Committee, Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2181264354, E-mail:
| | - Behzad Einollahi
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
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Roque-Cuéllar MC, Sánchez B, García-Lozano JR, Praena-Fernández JM, Márquez-Galán JL, Núñez-Roldán A, Aguilar-Reina J. Hepatitis C virus-specific cellular immune responses in sustained virological responders with viral persistence in peripheral blood mononuclear cells. Liver Int 2014; 34:e80-8. [PMID: 24127783 DOI: 10.1111/liv.12320] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 09/02/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Hepatitis C virus (HCV)-RNA detection in peripheral blood mononuclear cells (PBMCs) after recovery from HCV infection, is a type of occult HCV infection although is unclear how the viral persistence in PBMCs affects HCV-specific T-cell responses. The aim of this study was to investigate if cellular immune responses are modified by HCV persistence in PBMCs. METHODS HCV-specific CD4(+) and CD8(+) T-cell responses against six HCV peptides, situated within the non-structural (NS) proteins NS3, NS4b and NS5b, were measured by flow cytometry-through intracellular detection of gamma interferon (IFN-γ) or interleukin 4 (IL-4) and CD69 expression- in 27 sustained virological responders (SVR): 13 with and 14 without occult HCV infection in PBMCs, detected by strand-specific real-time PCR. Ten healthy individuals and 14 chronically infected patients with viraemia, were included as controls. RESULTS SVR without occult infection showed a higher percentage of activated CD4(+) cells against peptides belonging to NS3 (p124, p153) and NS5b (p257, p294), activated CD8(+) cells against NS3 (p124, p153, p158) and NS5b-p294, as well as an elevated percentage of CD4(+) cells releasing IFN-γ + IL-4 against NS3-p153, and by CD8(+) cells against NS3 (p124, p153). SVR without occult infection showed a higher percentage of activation and release of IFN-γ + IL-4 by both cell subpopulations than the two group of controls, in contrast to SVR with occult infection. CONCLUSION The lower HCV-specific T-cell response found in SVR with occult infection indicates that the immune response may be impaired when the virus persists in PBMCs.
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Affiliation(s)
- María C Roque-Cuéllar
- Biomedicine Institute of Seville (IBIS), University of Seville CSIC, University Hospital Virgen del Rocio, Seville, Spain
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