ABSTRACT
BACKGROUND: The major transmission route of hepatitis C virus (HCV) is transfusion of blood or blood products. But transfusion history is found only in half of HCV infected patients. In half of the patients the transmission routes of HCV were not determined. We estimate the prevalence of anti HCV in family members of the patients with HCV. METHODS: We tested anti-HCV by using the second generation enzyme immunoassay and measured HCV-RNA by PCR (polymerase chain reaction). Serum samples from 135 adults who are family members of patients with anti-HCV positive liver disease were tested for serum aminotrasferase activities, hepatitis B viral markers by radioimmunoassay, and anti-HCV by EIA. RESULTS: anti-HCV positive rate in family members of the patients with HCV was 1.48% (2/135). This positive rate was not different from the studies of anti-HCV in general population in Korea (1.44%). CONCLUSION: Interfamilial transmission of HCV may probably occur, but it is uncommon being compare with other diseases such as HBV or HIV.
Subject(s)
Adult , Humans , Biomarkers , Hepacivirus , Hepatitis B , HIV , Immunoenzyme Techniques , Korea , Liver Diseases , Polymerase Chain Reaction , Prevalence , RadioimmunoassayABSTRACT
BACKGROUND: Currently the most common treatment modality of refractory ascites in patients with liver cirrhosis was large volume paracentesis, but this procedure usually needed albumin infusion and occasionally developed unwanted complications. By reason of albumin shortage in Korea and occasional unfavorable complications, we studied the usefulness of dialytic ultrafiltration as an another treatment modality of refractory ascites. METHODS: Dialytic ultrafiltration was done in 10 patients (total 48 times) with liver cirrhosis or hepatocellular carcinoma. Two drainage conduit (via 16 gauge angio-catheter) of input and output were made by puncture of patient's right and left lower quadrant abdomen. The initial ultrafiltration rate of dialyser was 250mL/min. Ascitic fluid was removed continuously until the filtration rate down at 50mL/min. After ultrafiltration, ascitic fluid contained concentrated albumin and large molecules was reinfused via input conduit. Pre-treatment and post-treatment level of blood chemistry, plasma renin concentration, aldosterone, and electrolytes in serum; total protein and albumin in ascites were measured. During the ultrafiltration, we closely observed the change of blood pressure, heart rates and mental status. RESULTS: The mean ultrafiltration time was 231+/-28min, ultrafiltrated volume was 5.15+/-1.41 L. During dialytic ultrafiltration, patient's blood pressure and heart rate were stable and there was no change of mental status. After dialytic ultrafiltration, blood urea nitrogen level significantly decreased from 30.5+/-23.7mg/dL to 25.7+/-20.2mg/dL; serum aldosterone level decreased from 807.3+/-301.1pg/ml to 431.1+/-187.2pg/ml in serum (P<0.01). The albumin level in the ascitic fluid significantly increased from 0.67+/-0.28g/dL to 1.90+/-1.16g/dL (P<0.01). Plasma renin concentration level tend to decreased (P=0.06). The patient's serum total protein, albumin, electrolytes, and creatinine were not changed. Complications of dialytic ultrafiltration were peritonitis (one case) and hypotension (one case). But these unwanted complications were readily managed by adequate antibiotics and intravenous fluid therapy. CONCLUSION: The dialytic ultrafiltration can be used effectively without albumin infusion in the treatment of refrartory ascites in patients with advanced liver cirrhosis.
Subject(s)
Humans , Abdomen , Aldosterone , Anti-Bacterial Agents , Ascites , Ascitic Fluid , Blood Pressure , Blood Urea Nitrogen , Carcinoma, Hepatocellular , Chemistry , Creatinine , Drainage , Electrolytes , Filtration , Fluid Therapy , Heart Rate , Hypotension , Korea , Liver Cirrhosis , Liver , Paracentesis , Patient Rights , Peritonitis , Plasma , Punctures , Renin , UltrafiltrationABSTRACT
BACKGROUND/AIMS: The transmission routes of HCV infection were not determined in the half of the HCV infected patients. So intrafamilial personal contact, sexual contact, vertical transmission and some vectors are supposed as a route of HCV infection. We investigated the prevalence of anti-HCV positivity in healthy Korean children and compared with the data from the healthy adults whether the vertical transmission is feasible. METHODS: Serum samples from 2,080 children in 8 elementary schools were tested for serum aminotransferases, hepatitis B viral markers by radioimmu- noassay, and anti-HCV by the third generation EIA. Sera from anti-HCV positive children were tested for HCV-RNA by RT-PCR. Six months later, same tests were repeated. RESULTS: Anti-HCV was positive in 17 children among 2,080(0.82%). Among 17 anti-HCV positive children, HCV-RNA was detected only in one case and the HCV genotype was type II by Okamotos classification. Anti-HCV was tested again in 7 of 17 anti-HCV positive children after 6 months later and all of these children were anti-HCV positive and additional 3 of 19 family members were anti-HCV positive. But HCV-RAN was not detected in alL CONCLUSION: Anti-HCV positive rate in children was 0.81%.