Presence of HCV RNA in peripheral blood mononuclear cells may predict patients response to interferon and ribavirin therapy

Hepatitis C virus infection in garbage pickers of different districts of Khyber Pakhtunkhwa, Pakistan

Hepatitis C Virus (HCV) is a significant health problem worldwide, especially in developing countries. Medical municipal waste pickers are at higher risk of exposure to infectious viral diseases. The current study aimed to explore HCV infection in different waste collectors. The objective of the current study was to investigate the incidence of HCV infection and associated risks among the waste collectors of five districts of Malakand Divisions and Bajaur district (old Bajaur agency) Khyber Pakhtunkhwa, Pakistan. During the study period (May-December 2017), blood samples were collected from 300 waste handlers and tested for anti-HCV antibodies using the ICT method. The results obtained from the data were analyzed statistically using SPSS 20 version. In this study, we included 300 males aged 9 to 76 years, which means 27.31 ± 11.9 years. The prevalence of HCV was 3.3% (10/300). Among the positive cases, HCV infection was slightly higher in married persons than in unmarried (3% vs. 0.33%, %, PV < 0.01, odds ratio 4.73, 95% CI =2.2-9.8). A high infection rate was reported in waste scavengers from the district Swat, followed by those in the Bajaur district. Needle prick injuries and barehanded practices were the significant risk factors for infected cases. Our findings highlight the need for personal protective equipment. It is suggested that all garbage collectors should be trained in handling waste to reduce infection.

Early detection of Ebola virus proteins in peripheral blood mononuclear cells from infected mice

Background

Detection of viral ribo-nucleic acid (RNA) via real-time polymerase chain reaction (RT-PCR) is the gold standard for the detection of Ebola virus (EBOV) during acute infection. However, the earliest window for viral RNA detection in blood samples is 48–72 h post-onset of symptoms. Therefore, efforts to develop additional orthogonal assays using complementary immunological and serological technologies are still needed to provide simplified methodology for field diagnostics. Furthermore, unlike RT-PCR tests, immunoassays that target viral proteins and/or early host responses are less susceptible to sequence erosion due to viral genetic drift. Although virus is shed into the bloodstream from infected cells, the wide dynamic range of proteins in blood plasma makes this a difficult sample matrix for the detection of low-abundant viral proteins. We hypothesized that the isolation of peripheral blood mononuclear cells (PBMCs), which are the first cellular targets of the Ebola virus (EBOV), may provide an enriched source of viral proteins.

Methods

A mouse infection model that employs a mouse-adapted EBOV (MaEBOV) was chosen as a proof-of-principal experimental paradigm to determine if viral proteins present in PBMCs can help diagnose EBOV infection pre-symptomatically. We employed a liquid chromatography coupled with tandem mass spectrometry (LC–MS/MS) platform to provide both high sensitivity and specificity for the detection and relative quantitation of viral proteins in PBMCs collected during MaEBOV infection. Blood samples pooled from animals at the post-infection time-points were used to determine the viral load by RT-PCR and purify PBMCs.

Results

Using quantitative LC-MS/MS, we detected two EBOV proteins (vp40 and nucleoprotein) in samples collected on Day 2 post-infection, which was also the first day of detectable viremia via RT-PCR. These results were confirmed via western blot which was performed on identical PBMC lysates from each post-infection time point.

Conclusions

While mass spectrometry is not currently amenable to field diagnostics, these results suggest that viral protein enrichment in PBMCs in tandem with highly sensitive immunoassays platforms, could lead to the development of a rapid, high-throughput diagnostic platform for pre-symptomatic detection of EBOV infection.

An unusual case of renal dysfunction and hepatocellular carcinoma following sofosbuvir therapy

HCV is the major cause of morbidity and mortality worldwide with more than 185 million affectees. Currently, direct-acting antiviral drugs are being used as standard treatment approach that directly target HCV genes to eradicate virus and prevent cirrhosis. Accumulating evidence has reported that more than 90% HCV patients achieve sustained virological response. Adverse drug reactions of interferon-free regimens have not been studied yet. This is the first evidence of renal impairment and hepatocellular carcinoma following direct-acting antiviral drug therapy.