RESUMO
The aim of this study was to evaluate the prevalence of antibodies to hepatitis C virus (anti-HCV) in health-care workers (HCW). Sera from 439 unselected HCW were assessed for anti-HCV by 2nd generation enzyme-linked immunoassay (ELISA) and anti-HBc by ELISA. Anti-HCV (+) sera were evaluated by line immunoassay (LIA) (LiaTeK, Organon). Anti-HCV proved positive by ELISA in 12 (2.73
) subjects, 6 of whom were reactive by LIA, one was indeterminate and 5 non reactive. The prevalence of anti-HCV confirmed by LIA was 1.59
(7 subjects). Positive anti-HCV results with an ELISA ratio greater than 3 were LIA reactive in 6/6 as compared with 5 LIA non reactive with an ELISA ratio less than 2, while in the indeterminate serum the ratio was 2.5. No differences in age, profession, seniority, history of hepatitis or transfusions were found between anti-HCV (+) and (-) subjects, but females predominate significantly. The areas of higher risk were hemodialysis, obstetrics, surgery and intensive care. Anti-HBc was (+) in 85.7
(6/7) of the anti-HCV (+) subjects. Follow-up of anti-HCV (+) subjects showed raised alaninoaminotransferase levels in 4 cases, while liver biopsies in 3 disclosed cirrhosis, chronic active hepatitis and chronic persistent hepatitis. The anti-HCV prevalence in HCW is low compared with other risk groups perhaps due to the peculiar epidemiological features of HCV. In low risk groups for HCV infection a positive ELISA result with a ratio lower than 3 should be confirmed by more specific tests.
RESUMO
The risk of HBV and HCV liver infection in kidney graft recipients was evaluated in 35 patients. All were tested for anti-HBc, HBsAg, HBeAg, anti-HBs, Anti-HBe, anti-HCV (c-100-3 and c-100-3, c-22, 33-c), anti-HDV and anti-HIV by ELISA, and for HBV-DNA by hybridization. Liver biopsy, immunostaining for HBcAg and Knodells hepatic inflammatory index were performed in 18. Mean time elapsing form transplant to inclusion was 20.7 months (range 1-108). HBsAg was the only marker searched for prior to transplant. Twenty six (74.2
) HBsAg+, (3 HBeAg+ and 3 anti-HBe+), 7 (20
) anti-HBs+ and 3 (8.5
) isolated anti-HBc. Anti-HCV (C-100-3) was positive in 9/32 (28.1
), while 2nd. generation anti-HCV was positive in 20/35 (57.1
) cases. No false positives for 1st. generation test were found. Both anti-HDV and anti-HIV were negative in all the sample. Raised aminotransferases were present in 13/30 (43.3
), 7 in anti-HCV+, one in HBsAg+ and 3 in HBsAg+/HCV+ cases, but normal in 17/30 (56.6
). History of Transfusion and Hemodialysis time showed no significant differences between anti-HCV+ and anti-HCV negative cases. Biopsy disclosed 10 chronic persistent hepatitis (CPH), one chronic active hepatitis (CAH) with cirrhosis, one inactive cirrhosis (Ci) 4 minimal lesions (MHL) and 2 normal. Seven CPH, 3 MHL. one normal and both cirrhosis cases proved anti-HCV+. HBsAg was positive in the single CAH, in 2 CPH and in one MHL.(ABSTRACT TRUNCATED AT 250 WORDS)