Prevalence of HCV Antibody and its Associated Factors: A Study from Sentinel Hospitals in China / 生物医学与环境科学（英文）

OBJECTIVE@#The prevalence and related factors of serum anti-HCV in different regions and hospitals have not been studied extensively in China. We used routine screening data to determine the prevalence of HCV antibody in hospital patients, evaluate the epidemic trend of hepatitis C and formulate screening strategies.@*METHODS@#Patient information and HCV antibody testing results were collected from January 2017 to December 2019 in 77 HCV sentinel hospitals in China. Univariate and multivariate logistic regression was used to determine the characteristics and associations.@*RESULTS@#HCV antibody prevalence rates were distinct among patients in different departments, with a range of 0.33%-6.93%. Patients who were admitted to the liver disease-related departments (a OR = 10.76; 95% CI, 10.27-11.28), Internal Medicine (a OR = 2.87; 95% CI, 2.75-3.00), and Department of Surgery (a OR = 1.95; 95% CI, 1.87-2.04), were more likely to be tested for HCV antibody positive. HCV antibody prevalence was associated with patients aged 45 years and older (a OR = 2.74; 95% CI, 2.69-2.80), testing in infetious disease hospitals (a OR = 2.33; 95% CI, 2.26-2.40) and secondary hospitals (a OR = 1.72; 95% CI, 1.69-1.75). Patients in sentinel hospitals of the Northeast (a OR = 12.75; 95% CI, 12.40-13.11), the Central (a OR = 1.65; 95% CI, 1.61-1.70), and the West (a OR = 1.78; 95% CI, 1.73-1.83) China had higher HCV prevalence than those who were in the Eastern coastal area.@*CONCLUSION@#Those who were over 45 years old and saw doctors for liver diseases, and invasive diagnosis and treatment should be referred to HCV antibody testing.

Performance evaluation of two chemiluminescence immunoassay reagents for HCV antibody in blood donors screening / 中国输血杂志

【Objective】 Aim of this study was to evaluate performance of two chemiluminescence immunoassay (CLIA) reagents for hepatitis C virus antibodies (anti-HCV) detection, focusing on the feasibility of blood screening for blood donors. 【Methods】 The sero-panel samples from NCCL and the donor samples were tested with CLIA, ECLIA and two ELISA (A: double antigen sandwich method, B: indirect method) reagents synchronously to evaluate their performances respectively, and the sensitivity, specificity and CV of the four reagents were compared. 【Results】 CLIA, ECLIA, A and B reagents showed sensitivities of 99.06%(315/318), 99.69%(317/318), 99.06%(315/318) and 99.69%(317/318), and clinical specificities was 99.06%(315/318), 99.69%(317/318), 99.06%(315/318) and 99.69%(317/318), respectively. Between-run and within-run precision for ECLIA reagent ranged (both CV<8%) was better than two ELISA reagents (between-run: CV <15% and within-run: CV <20%), and the CLIA reagent also met the requirement in blood screening (CVs <14%). 【Conclusion】 This ECLIA reagent showed high sensitivity and good reproducibility together with acceptable specificity in routine sample screening, which proved its further application in blood screening. This CLIA reagent has high specificity and the same sensitivity as indirect ELISA reagent. This CLIA reagent could be used in combination with other reagents with high sensitivity to screen anti-HCV in blood donors.

Accelerated decline in anti-HCV antibody levels in spontaneous HCV seroconverters with HIV co-in-fection / 中华微生物学和免疫学杂志

Objective To investigate the influence on anti-HCV antibody levels in spontaneous HCV seroconverters co-infected with HIV. Methods A retrospective study was conducted on people with a history of blood donation in Wangying Village,Shangcai County,Henan Province in 2009 and 2017. Accord-ing to the infection status in 2009,patients who were positive for anti-HCV antibody were divided into four groups:HIV-negative chronic HCV infection group (HCVc),HIV-negative spontaneous HCV clearance group (HCVr),HIV-positive chronic HCV infection group (HIV+HCVc),HIV-positive spontaneous HCV clear-ance group ( HIV+HCVr). All patients were followed up in 2017 and those who were lost to follow-up, received HCV treatment or were reinfected with HCV (only for those of HCV seroconverters) were excluded from this study. Altogether 167 patients met the inclusion criteria (HCVc:n=65;HCVr:n=34;HIV+HCVc:n=44;HIV+HCVr:n=24). A horizontal comparison of anti-HCV antibody levels among the above four groups in 2009 and a longitudinal comparison of changes in anti-HCV antibody in each group from 2009 to 2017 were respectively conducted. Results The horizontal comparison indicated that the levels of anti-HCV antibody were higher in chronic HCV-infected patients than in HCV seroconverters no matter whether they were co-infected with HIV or not (both P<0. 000 1). After comparison of anti-HCV antibody titers in 2017 and 2009,no significant changes were found in HCVc or HIV+HCVc group. The levels of anti-HCV antibody in HCVr and HIV+HCVr groups decreased significantly from 2009 to 2017 ( both P<0. 000 1). HIV+HCVr group showed a faster decline in anti-HCV antibody level than HCVr group (P=0. 003 9). Significant nega-tive correlations between the decline speed in anti-HCV antibody sample/cut-off ( S/CO) values and the initial anti-HCV antibody S/CO values (in 2009) were found in both HCVr (r=-0. 517 7, P=0. 001 7) and HIV+HCVr groups (r=-0. 753 2, P<0. 000 1). The decline speed in anti-HCV antibody in HIV+HCVr patients was found to be negatively correlated with their CD4+T cell counts in 2009 ( r=-0. 563 8, P=0. 004 1). Moreover,the seroreversion rate of anti-HCV antibody in patients of the HIV+HCVr group was higher than that of HCVr group (P=0. 027 5). Conclusion HIV co-infection can accelerate the decline of anti-HCV antibody in spontaneous HCV seroconverters. This study indicates that in a large-scale retrospective epidemiological investigation especially for HIV-infected populations, the prevalence of anti-HCV antibody may be underestimated.

Hepatitis crónica en pacientes, donantes o no de sangre, con anticuerpo al virus de la hepatitis C positivo / Chronic Hepatitis in Donors and Non-Blood Donors with Positive Antibodies to the Virus C

Introducción: la infección por el virus de la hepatitis C (VHC), problema de salud mundial, es una de las principales causas de hepatitis crónica y cirrosis hepática. Objetivo: identificar si existen diferencias en la frecuencia de presentación de la hepatitis crónica y sus características clínicas, humorales e histopatológicas, entre donantes y no donantes de sangre con anticuerpos al VHC (anti-VHC) positivo. Métodos: el universo de estudio estuvo compuesto por la totalidad de pacientes con anti-VHC positivo, diagnosticado por ultramicroelisa en el Banco Provincial de Sangre, atendidos entre enero 2000-diciembre 2011, en una Consulta Especializada del Hospital General Universitario Vladimir Ilich Lenin de Holguín. Se realizó biopsia hepática a los pacientes. Se seleccionaron dos muestras intencionadas de pacientes con diagnóstico de hepatitis crónica, grupo estudio, 46 donantes y grupo control, 17 no donantes, sin antígeno de superficie del virus B o tratamiento previo de interferón y ribavirina. Resultados: la hepatitis crónica fue mayor (P<0,05) en el grupo control, con formas activas más severas con o sin fibrosis (P<0,001), y alaninoaminotransferasas (ALAT) alteradas (p<0,001), a diferencia del grupo estudio con predominio de hepatitis con actividad ligera o mínima y ALAT normales. Los donantes sintomáticos fueron minoría a diferencia (p<0,001) de los no donantes, 82% con síntomas, en orden decreciente: astenia (14), molestia en hipocondrio derecho (12) y dispepsia (7). Conclusiones: la menor frecuencia de hepatitis crónica con anti-VHC positivo, en los donantes de sangre, con predominio de la actividad mínima y ligera, pudiera deberse al diagnóstico precoz en etapas iníciales de la enfermedad. Los donantes asintomáticos con transaminasas normales preponderaron, sobre los no donantes, lo que pudiera corresponderse con la magnitud de la actividad y el estadio de la hepatitis crónica en aquellos.

Introduction: the hepatitis C virus infection, problem of worldwide health is one of the main causes of chronic hepatitis and liver cirrhosis. Objective: to identify whether there are differences in the frequency of occurrence of chronic hepatitis and their clinical characteristics, humoral and pathological, between donors and non-blood donors with antibodies to HCV (anti-HCV) positive Methods: the study group comprised all patients with anti-HCV positive, diagnosed by ultramicroelisa in Provincial Blood Bank, treated from January 2000 to December 2011, in General University Hospital Vladimir Ilich Lenin of Holguin. Liver biopsy was performed to patients. Two intentional samples were selected: patients diagnosed with chronic hepatitis study group and control group 46 donors, 17 non-blood donors without virus surface antigen pretreatment B or interferon and ribavirin. Results: chronic hepatitis was higher (P <0.05) in the control group, with more active forms with or without severe fibrosis (P <0.001), and alaninoaminotransferasas (ALAT) altered (p <0.001), unlike the study group prevalence of hepatitis with mild activity or minimal and normal ALAT. Donors were minority symptomatic difference (p <0.001) than non-donors, 82% with symptoms, in decreasing order: asthenia (14), right upper quadrant discomfort (12) and dyspepsia (7). Conclusions: the lower frequency of chronic hepatitis with positive HCV in blood donors, predominantly minimal to slight activity, could be due to early diagnosis in early stages of the disease. Asymptomatic donors with normal transaminases predominated on non-donors, which could correspond to the magnitude of the activity and stage of chronic hepatitis those ones.

Seroprevalence of anti-HCV antibodies in HIV positive persons at G.G. Hospital Jamnagar.

Objective: Hepatitis is a major public health problem throughout the world affecting several hundred million of people. Aim is to study incidence of HIV seropositivity in blood donors and suspected patients attending voluntary council and testing centre and to compare prevalence of Anti HCV antibody positivity in HIV seropositive samples. Material and Methods: A total of 1786 serum samples were tested for HIV antibodies in patients attending Voluntary Council and Testing Centre (VCTC) at Guru Govind Singh Hospital, Jamnagar. The serum sample of HIV seropositive patients were tested for HCV antibodies. Those serum samples found positive for Anti-HCV antibody were reconfirmed by Signal HCV method. Out of total 1786 samples for HIV 297 patients were positive (16.63%) for HIV and 1489 patients were negative (83.37%) for HIV. Discussion: As the hepatitis C virus has capacity to induce chronicity that leads to cirrhosis and liver cancer in long term. In the absence of vaccine and effective chemotherapy, screening of more and more serum samples is the only way to prevent post transfusion hepatitis C virus infection.

A Case of Acute Disseminated Encephalomyelitis Associated with Hepatitis C Virus Infection

Acute disseminated encephalomyelitis (ADEM) is a monophasic autoimmune demyelinating disease of the central nervous system, which typically follows acute viral or bacterial infection or vaccination. We report a case of ADEM associated with hepatitis C virus (HCV) infection with positive serum and cerebrospinal fluid (CSF) anti-HCV antibody. After steroid treatment, neurologic symptoms were improved. Virus triggers autoimmunity or direct viral invasion plays a part in the genesis of ADEM. This is the first reported case of ADEM with anti-HCV antibody in the CSF.

The clinical application and analysis of hepatitis C virus NS3 antigen detection by ELISA in human serum / 中华微生物学和免疫学杂志

Objective To evaluate the specificity and sensitivity of a Hove]hepatitis C virus NS3 antigen detection immunoassay and the potential application of this assay in clinical diagnosis.Methods Samples from 77 healthy flubjects,173 anti-HCV-positive pailents and 3708 patients infected with other type of hepatitis were tested with the HCV NS3 antigen assay,some HCV NS3 antigen positive samples were validated witll HCV-RNA.neutralization and immunodot assays.Twenty.five sequential samples from 11 HCV NS3 antigen positive patients were subjected to kinetic studv.Results Forty-eight(1.3%)of 3708 antiHCV negative samples were positive for HCV NS3 antigen.Among them,44 of 3030 samples from patients only infected with HBV were HCV NS3 antigen-positive,4 of the 445 samples from patients infected with other type hepatitis were HCV NS,antigen-positive.In addition.42(24.3%)of 173 anti-HCV positive samplea were HCV NS3 antigen-positive and all 77 samples from healthy subjects were negative to HCV NS3 antigen assay.Of 15 HCV NSl antigen-positive samples,9(60%)were HCV-RNA positive.The neutralization and positive percentage of immunodot assay for 23 HCV NS3 antigen-positive sera were 87.0%(20/23)and 69.6%(16/23) respectively.Of the 25 sequential samples from 11 HCV NS3 antigen positive patients,there was a negative correlation between the A values and the duration of test.and there were correlations among their HCV NS3 antigen.HCV.RNA and anti-HCV;In addition,the anti-HCV antibodies of two sera were detected while their A values of HCV NS3 antigen decreased gradually.Conclusion The HCV NS3 antigen detection assay showed perfect specificity and higher sensitivity,it will be useful in routine laboratories test in developing countfies for earlier diagnosis of HCV infection.

Hepatitis C aguda: Acute hepatitis C

La hepatitis C aguda es una enfermedad generalmente subclínica, de ahí que no se incluya en el diagnóstico diferencial de los pacientes con un cuadro agudo. Además diagnosticarla presenta dificultades ya que los anticuerpos contra el virus tardan en aparecer, pudiendo ser negativos cuando el paciente manifiesta los síntomas; en este punto la enfermedad podría diagnosticarse con el RNA viral, pero éste no es fácil que sea solicitado inicialmente. Se presenta un paciente que ingresó por una hepatitis aguda en el que se descartaron causas virales como hepatitis A-B, Ebstein Barr, Citomegalovirus (CMV) hepatitis autoinmune, hepatotoxicidad y enfermedad hipoxicoisquémica, que explicaran la sintomatología y los hallazgos bioquímicos del paciente, en quien se demostró seroconversión contra el virus de la hepatitis C asociado a una carga viral elevada. Todo lo anterior es consistente con un diagnóstico de hepatitis C aguda. Se describe el manejo del paciente y las características de la enfermedad.

Acute hepatitis C is usually a sub-clinical disease, thus it is not included in the differential diagnosis of patients with acute disease. Making the diagnosis is also difficult because the virus antibodies appear at later stages and many even be negative even if the patient has symptoms; at this point the diagnosis of the disease could be made with the viral RNA, but it is not easy to ask for it initially. A patient is admitted because of acute hepatitis where viral causes such as hepatitis A-B, Epstein Barr, Cytomegalovirus (CMV), auto-immune hepatitis, hepatoxitiy and hypoxic-isquemic disease, that would explain the symptoms and bio-chemical findings were discarded. The patient’s seroconversion against Hepatitis C virus associated to a high viral load was demonstrated. All this is consistent with an acute Hepatitis C diagnosis. Patient’s management and disease characteristics are described. (Acta Med Colomb 2008; 33: 28-32).

Detection of antibodies against the hypervariable region 1 of hepatitis C virus / 中国输血杂志

Objective To detect antibodies against the hypervariable region 1(HVR1) of hepatitis C virus in blood screening.Methods The HVR1 antibodies were detected by F4HVR1 antigen,and then were compared with other antibodies of HCV.Results Among HCV-RNA positive samples,HVR1 antibody was 96.8% positive.The positive rate of HVR1 antibodies in 90 suspected HCV-infected samples was 61.1%,which was close to those against C and NS3,and higher than NS4 and NS5(P

Soroprevalência da hepatite C em pacientes hemodialisados / Hepatitis C serum prevalence in hemodialyzed patients

Os objetivos deste estudo foram estimar a soroprevalência da infecção pelo vírus da hepatite C em um centro de diálise da grande Recife; e associar a soropositividade para o vírus da hepatite C em relação a alguns fatores de risco. Foram analisados 250 pacientes com idade variando de 17 a 92 anos e de ambos os sexos. Dados epidemiológicos desses pacientes foram obtidos para a determinação dos fatores de riscos para esta infecção. A pesquisa de anticorpos anti-HCV foi realizada pelo ELISA de 4ª geração. Foi observado que em relação aos fatores de riscos, como o tempo de hemodiálise, número e período das transfusões de hemocomponentes, foi encontrada uma associação estatisticamente significante (p< 0,05). A prevalência encontrada foi baixa (8,4 por cento) em relação a outros estudos do Brasil. Entretanto, seriam necessários mais estudos em outros centros a fim de estimar a real prevalência para infecção pelo vírus da hepatite C em pacientes submetidos a hemodiálise em Pernambuco.

The objectives of this study were to estimate the serum prevalence of hepatitis C virus (HCV) infection in a dialysis center in the greater Recife region, and to correlate HCV serum positivity with some risk factors. Analyses were performed on 250 patients of both sexes, with ages ranging from 17 to 92 years old. Epidemiological data on these patients were obtained in order to determine the risk factors for this infection. Anti-HCV antibodies were investigated using fourth-generation ELISA. Statistically significant associations (p < 0.05) were observed in relation to the risk factors of hemodialysis duration, number of blood component transfusions and time taken for transfusions. The prevalence was low (8.4 percent) in relation to other Brazilian studies. However, more studies in other centers are needed in order to estimate the real prevalence of HCV infection among patients undergoing hemodialysis in the State of Pernambuco.

Detection of Differences in Light Chain Isotype (?/?) Expression of Anti-HCV Antibodies after HCV Infection and Its Clinical Significance / 中国医师杂志

Objective To study the cause of protective immunodeficiency of patients with hepatitis C. Methods An antigen capture ELISA in which HCV synthetic peptides SP42, CP10 and CP9 derived from HCV NS4 and core gene region, respectively, were used as solid-phase antigens was used to detect the differences in light chain isotype expression of anti-HCV antibodies. Results Antibodies in 84 sera of HCV-infected patients against HCV SP42, CP10 and CP9 were characterized by a skewed light chain isotype expression. Eighty-two out of 84 sera of HCV infection (97 62%) showed at least one of the three anti-HCV antibodies skewed from the normal ratio of light chain isotype kappa/lambda. The kappa/lambda ratios of anti-HCV antibodies in all patients with hepatitis C were found to be unique and constant during one year follow-up, and 11 of them received two years follow-up. Conclusions Anti-HCV response was stable and clonally restricted in HCV infection. B-cell clonal dominance may be the cause of human protective immunodeficiency after HCV infection.

Changes in the Positivities of HBsAg and Anti-HCV Antibody among Army Draftees in Korea / 대한간학회지

BACKGROUND/AIMS: Before the introduction of the HBV vaccination programs, the positivity of HBsAg among the general population was reported to be around 8% in Korea. Although recent reports revealed somewhat decreased values, a wide range of variation exists according to the authors. Major movements to control HBV infection include the programs such as the introduction of HBV vaccination in 1983, mass inoculation of the elementary school children since 1988 and inclusion of type B hepatitis in 1995 in Class III legal epidemics. The purpose of the present study was to examine the changing trend of the positivities of HBsAg, HBeAg and anti-HCV in army draftees in Korea since we believed that they are an ideal study group with a set of fixed variables such as gender and age. METHODS: From January 1, 1993 to December 31, 1999, we evaluated a total of 498,206 male army draftees for serum ALT, HBsAg, HBeAg and anti-HCV antibody. HBsAg (Genedia, Yongin, Korea) and HBeAg (Amrad, Austrailia) were examined by EIA and Immunochromatography, respectively. Anti-HCV antibody was tested by 3rd generation EIA (Genedia, Yongin, Korea). Serum ALT was determined by autoanalyser, Polystat 2000 (Hitachi, Japan). RESULTS: The majority of the draftees were 20 years old (68.8%). The positivity of HBsAg gradually decreased from 5.8% in 1993 to 4.3% in 1999(mean 4.8%). The positivity of HBeAg among the asymptomatic HBsAg carriers ranged from 47.9% to 55.6%(mean 51.8%). The positivity of anti-HCV antibody was seen in the range from 0.09% to 0.29%(mean 0.18%), and 84.5% showed normal ALT. The positivity of HBsAg among the anti-HCV positive subjects was 6.6%. CONCLUSION: The HBsAg positivity has significantly(p=0.001) decreased for the past 7 years. However, the positivity of anti-HCV antibody showed no significant pattern of change during the same period.

Experience of Anti-HCV antibody immunoblot test in Korean Blood Donors / 대한수혈학회지

BACKGROUND: All donated bloods collected by the Korean Red Cross Blood Centers are tested for anti-HCV (Hepatitis C Virus) antibody by enzyme immunoassay (EIA) kits made in Korea. EIA test has sustaining problem of false positivity in spite of great progress in manufacturing kits. So, many healthy donors have been reported as being infected with HCV and excluded from next donation. METHODS: Among blood samples of 2,040,151 donors which were tested by two kinds of EIA kits (DONG-A HCV 3.0 and LG HCD 3.0) from 16 blood centers during 12 months, repeatably reactive samples, total 6,851 samples, were supplementally tested by LG HCD CONFIRM immunoblot test. RESULTS: Positive, indeterminate and negative rate in immunoblot tests were 39%, 9%, and 12% respectively among 6,851 repeatably reactive samples. Estimated true positive rate of anti-HCV antibody in Korean blood donors was 0.13%, showing geographical difference between 0.03% and 0.46%. Of EIA repeatably reactive samples, 28% showed greater than 5 signal to cutoff (S/C) ratio and most of them (94%) was revealed to be positive. CONCLUSION: True positive rate of EIA test results is so low that it would be necessary to increase the confidence of such results by immunoblot tests.

Occupational Distribution of Anti-HCV Immunoblot Positive Donors and Anti-HIV Westernblot Postive Donors in Korea / 대한수혈학회지

BACKGROUND: It is widely known that approximately 99.4% of the safety of the blood supply can be met by the careful history taking of donors. In Korea, however, it is generally accepted that there is difficulty in doing careful history taking because donors are mainly recruited from school or army. This study is focused on analyzing the occupational distribution of anti-HCV or anti-HIV antibody positive donors and re-emphasizing the importance of careful history taking for donors. METHODS: Occupation of antibody positive donors was seaeched out from the computer database of the Korean National Red Cross. For the analysis of anti-HCV immunoblot positive donors, database from Jan. 1996 to Dec. 1996 were used. For the anti-HIV Western blot postive donors, database from 1992 to 1996 were used. RESULTS: 2,761 donors were anti-HCV immunoblot positive and searched out for their occupation. (Additional 80 donors were immunoblot positive, but could not be identified from the computer database.). 82% (2,269 donors) of 2,761 donors was not in the group of Students and Soldiers. Anti-HCV immunoblot positive donors were there in Others (1,015 donors) and in Salariate (820 donors) and in Merchants (313 donors). So, positive rate was the highest in Merchants (0.70%) and the second was others (0.44%). Occupational distribution of anti-HIV westernblot positive donors was nearly the same as that of anti-HCV immunoblot positive donors. CONCLUSION: 82% of anti-HCV immunoblot positive donors was not in the group of students and soldiers. Futhermore, occupational distribution of anti-HIV antibody positive donors was nearly the same as that of anti-HCV antibody positive donors. So, if blood collection staff would try to take a medical histroy carefully for donors, even only for individual donors who visit donation room alone or with a few friends, many risky donors may be excluded from donation, and thereby the safety of blood could be increased by appreciable amount in Korean blood donation program.