Seroprevalence of HCV markers among HIV infected patients from Curitiba and metropolitan region / Soroprevalência de marcadores do vírus da hepatite C (HCV) em pacientes infectados com HIV de Curitiba e Região Metropolitana

SUMMARY Objective: to determine the prevalence and epidemiological factors associated with hepatitis (HCV) coinfection in human immunodeficiency virus (HIV) patients from Curitiba and the metropolitan region. Methods: a study with 303 HIV+ patients, mean age 41.2 years (18-73); 50.5% men, followed at the Hospital de Clínicas, Universidade Federal do Paraná, between April 2008 and March 2009. Clinical and epidemiological data were obtained through questionnaires and retrospective analysis of medical records. Anti-HCV antibodies were detected by chemiluminescence immunoassay. Results: a total of 12.9% of HIV+ patients were positive for anti-HCV antibodies, 64.1% were men and 35.9% women, with mean age of 44.5 years (24-66). The frequency of HCV among men was 16.7% and among women 9.1% (p=0.06). HCV prevalence was associated to HIV infection when compared to the general population (p<10-6, OR=100.4; 95CI=13.7-734.9). The parenteral route of transmission was the most frequent among coinfected patients (46.1%), and the sexual transmission among HIV+/HCV- (71.8%) (p=0.02, OR=0.2; 95CI=0.1-0.7). The frequency of intravenous drug users was higher among the coinfected patients (61.5%) compared to the non coinfected (12.6%) (p<10-6, OR=11.1; 95CI=4.5-27.7). Conclusion: the prevalence of coinfection with HCV in HIV+ patients is 12.9%, 88 times higher than in the general population in Curitiba. The most frequent route of transmission in the coinfected patients is parenteral, but the sexual route is also representative (34.6%).

RESUMO Soroprevalência de marcadores do vírus da hepatite C (HCV) em pacientes infectados com HIV de Curitiba e Região Metropolitana Objetivo: verificar a prevalência e caracterizar fatores epidemiológicos associados à coinfecção por HCV em pacientes HIV+ de Curitiba e Região Metropolitana. Métodos: estudo envolvendo 303 pacientes HIV+, com idade média de 41,2 anos (18-73); 50,5% homens; acompanhados no Hospital de Clínicas da Universidade Federal do Paraná, entre abril de 2008 e março de 2009. Os dados clínico-epidemiológicos foram obtidos por meio de questionários e análise retrospectiva dos prontuários. Os anticorpos anti-HCV foram detectados por ensaio imunoenzimático quimioluminescente. Resultados: dos pacientes HIV+, 12,9% apresentaram sorologia positiva para o HCV, sendo 64,1% homens e 35,9% mulheres, com idade média de 44,5 anos (24-66). A frequência nos homens foi de 16,7%, e nas mulheres, 9,1% (p=0,06). A prevalência do HCV foi significativamente associada à infecção por HIV quando comparada à população geral (p<10-6, OR=100,4; IC95%=13,7-734,9). A via de transmissão parenteral foi a mais frequente entre os coinfectados (46,1%), e a sexual, a mais frequente entre os não coinfectados (71,8%) (p=0,02, OR=0,2; IC95%=0,1-0,7). A frequência de usuários de drogas injetáveis foi maior entre os coinfectados (61,5%) do que entre os não coinfectados (12,6%) (p<10-6, OR=11,1; IC95%=4,5-27,7). Conclusões: a prevalência da infecção por HCV nos pacientes HIV+ é de 12,9%, 88 vezes maior que a infecção na população geral de Curitiba. A via de transmissão mais frequente entre os coinfectados foi a parenteral, porém, a via sexual também é representativa para a transmissão do HCV (34,6%).

Seroprevalence of HCV antibody among patients with B-Thalassemia major in amirkola thalassemia center, Iran

Beta- thalassemia major is a common hemoglobinopathy in humans. In some journals, numerous studies have reported different prevalence of hepatitis C among beta-thalassemia major because thalassemic patients need multiple blood transfusions and blood transfusion is a common transmission pathway for hepatitis C virus. Thus this study was performed for detection of anti-HCV between beta- thalassemia major patients in our region

Transmisión familiar del virus de la hepatitis C en un grupo de población chilena / Familial transmission of hepatitis C virus infection in Chilean subjects

BACKGROUND: Intravenous drug use, sexual promiscuity and a longer cohabitation period are considered risk factors for familial transmission of hepatitis C virus. The relative importance of this type of transmission is a subject of controversy. AIM: To study familial clustering of hepatitis C virus infection and its risk factors. MATERIAL AND METHODS: HCV positive patients (91 with chronic hepatitis, 88 with cirrhosis, nine with hepatic carcinoma and 29 hemophiliacs) were the index cases. HCV antibodies were measured by ELISA and the type of relationship with the index case was investigated in 317 family members. RESULTS: Positive anti HVC antibodies were detected in 12 of 243 family members of patients with chronic liver disease and in none of the family members of patients with hemophilia. Of these, five were couples of an index case with a long cohabitation period. Ten members had an index case with a severe liver disease (three with Child C cirrhosis and seven with liver carcinoma). CONCLUSIONS: Family transmission of HCV infection is uncommon in Chile. The association of severe liver disease and family transmission could be due to a higher viral load as responsible for transmission during the early periods of a long lasting disease.

study of serological markers of hepatitis B and C viruses in Istanbul, Turkey

This study was undertaken to investigate the prevalence of HBsAg, anti-HBs and anti-HCV positivity in Istanbul, Turkey. Subjects and The frequencies of HBsAg, anti-HBs and anti-HCV positivity were determined in 1,157 randomly selected patients attending the outpatient clinic of Istanbul University Hospital, Istanbul, Turkey, during the years 1998 and 2001. All patients underwent complete physical and various routine laboratory examinations. Of the 1,157 patients, the prevalence of HBsAg, anti-HBs and anti-HCV was 6.6, 28.1 and 2.4%, respectively. It appeared that having dental and surgical procedures formed the risk factors for HBV infection. HBsAg positivity in the health care workers was not different from that of the other professions, but anti-HBs was significantly higher in this group. Conclusions: Our findings indicate that HBV infection occurs more frequently than HCV in Istanbul, and this poses an important health problem in the community

Anti-HCV antibody among iranian IV drug users: is it a serious problem?

Hepatitis C virus [HCV] is transmitted mainly via sexual contacts and blood [or its products'] transfusion. Transmission of this virus by contaminated needles used by IV drug users has raised great concern. In the present survey, the rate of HCV infection among a group of IV drug users was investigated and some important risk factors of the virus transmission were determined. A total of 402 male IV drug users from Ghasr Prison in Tehran, Iran, entered the study [1995]. At the stage of blood sampling, a questionnaire including demographic data; history of blood transfusion, tattooing and cupping [or Hejamat, the traditional way of phlebotomy in Iran] was also filled for every enrolled prisoner. HCV 3.0 ELISA and RIBA II were used to detect the HCV antibody and antigen in blood sera, respectively. Data were analyzed using Chi-square and Fisher's exact tests. HCV antibody was found in the sera of 182 of 402 cases [45.3%]. Seventy-three of 182 [40.1%] HCV antibody-positive persons had a history of tattooing. All cases with a history of cupping were antibody positive. There was a statistically significant relationship between antibody positivity and having a history of tattooing/cupping [p< 0.005]. Other risk factors did not seem to have a significant relationship with HCV antibody positivity. Similar to the findings of many developed and developing countries, a high rate of hepatitis C infection is present among Iranian IV drug users. We believe that tattooing and cupping are two important risk factors associated with HCV infection in IV drug users in Iran

Evaluation of an enzyme immunoassay for hepatitis C virus antibody detection using a recombinant protein derived from the core region of hepatitis C virus genome

This study was undertaken to evaluate an enzyme immunoassay (EIA) for hepatitis C virus antibody detection (anti-HCV), using just one antigen. Anti-HCV EIA was designed to detect anti-HCV IgG using on the solid-phase a recombinant C22 antigen localized at the N-terminal end of the core region of HCV genome, produced by BioMérieux. The serum samples diluted in phosphate buffer saline were added to wells coated with the C22, and incubated. After washings, the wells were loaded with conjugated anti-IgG, and read in a microtiter plate reader (492 nm). Serum samples of 145 patients were divided in two groups: a control group of 39 patients with non-C hepatitis (10 acute hepatitis A, 10 acute hepatitis B, 9 chronic hepatitis B, and 10 autoimmune hepatitis) and a study group consisting of 106 patients with chronic HCV hepatitis. In the study group all patients had anti-HCV detected by a commercially available EIA (Abbott(r)), specific for HCV structural and nonstructural polypeptides, alanine aminotransferase elevation or positive serum HCV-RNA detected by nested-PCR. They also had a liver biopsy compatible with chronic hepatitis. The test was positive in 101 of the 106 (95 percent) sera from patients in the study group and negative in 38 of the 39 (97 percent) sera from those in the control group, showing an accuracy of 96 percent. According to these results, our EIA could be used to detect anti-HCV in the serum of patients infected with hepatitis C virus.

A clinical, epidemological, laboratorial, histological and ultrasonographical evaluation of anti-HCV EIA-2 positive blood donors

Between 1992 and 1997, 790 blood donors with anti-HCV EIA-2 strongly reagent (relationship between the sample optical density/cut-off > 3) detected at the blood bank serological screening, were evaluated in ambulatory environment. They were all negative for Chagas disease, syphilis, hepatitis B (HBsAg) and AIDS. Blood samples were collected at the first ambulatorial evaluation, for hemogram, biochemical tests and new serological tests for HCV (anti-HCV EIA-2). In blood samples of 226 repeatedly reagent anti-HCV EIA-2 blood donors, supplementary "immunoblot" test for HCV (RIBA-2) was used. In 209 donors, the presence of HCV-RNA was investigated by the PCR test. The abdominal ultrasonography was realized in 366 donors. In 269 patients liver biopsy was performed for the histopathological study. The follow-up of blood donors showed that 95.6 percent were repeatedly EIA-2 reagent, 94 percent were symptomless and denied any hepatitis history, with only 2 percent mentioning previous jaundice. In 47 percent of this population at least one risk factor has been detected for the HCV transmission, the use of intravenous drugs being the main one (27.8 percent). Blood transfusion was the second factor for HCV transmission (27.2 percent). Hepatomegaly was detected in 54 percent of the cases. Splenomegaly and signs of portal hypertension have seldom been found in the physical examination, indicating a low degree of hepatic compromising in HCV. Abdominal ultrasound showed alterations in 65 percent of the subjects, being the steatosis the most frequent (50 percent). In 83.5 percent of the donors submitted to the liver biopsy, the histopathological exam showed the presence of chronic hepatitis, usually classified as active (89 percent) with mild or moderate grade in most of the cases (99.5 percent). The histopathological exam of the liver was normal in 1.5 percent of blood donors. The RIBA-2 test and the HCV-RNA investigation by PCR were positive in respectively 91.6 and 75 percent of the anti-HCV EIA-2 reagent donors. The HCV-RNA research was positive in 82 percent of the RIBA-2 positive subjects, in 37.5 percent of the indeterminate RIBA-2 donors and in 9 percent of the negative RIBA-2 donors. Chronic hepatitis has also been observed in 50 percent of the histopathological exams of the anti-HCV EIA-2 reagent donors which were indeterminate RIBA-2...

Antibodies to hepatitis C virus among 34130 blood donors in Tunisian sahel

Since January 6th 1994 to December 31 1997. We researched hepatitis C Virus antibodies by second and third generation ELISA in 34130 bloods donors living in "Sahel Tunisien". 193 were positive [0.56 percent]. Only 171 of them were secondary tested by immunoblat assay [anticore, anti N55, anti NS3, Anti NS4]. Which was positive in 53 cases [30.9 percent]; indeterminated [presence of only one antibody] in 78 cases [45.6 percent] and negative, in 40 cases [23.3 percent]. There was a significant relation between a ratio over than 2.5 in ELISA and immunoblot positivity. Immune response to different hepatitis virus antigens were heterogenous with predo-minat indeterminated profile. [78/171 cases]. Most of donors of the last profile had either anti NS5 [32/78] or anti NS3 [33/78] and we excluded them even through usually negative in P.C.R. and associated with a very low risk of contamination

Pesquisaje del anti-hcv en pacientes trasfundidos, pertenecientes a un área de salud atendida por el médico de la familia. Consultorio Médico 19 de abril / Research of anti-HCV in patients transfused, in a health area attended by a physician of the family. Medical office 19 de abril

The infection by the virus the hepatitis C (VHC) constitutes a health problem at world level. This situation has resulted in numerous researchers developing and using different means of diagnosis in order to know the actual prevalence of the virus. The main way of VHC transmission is blood and/or haemoderivates transfusion. It has been estimated that 90 per cent of post-transfusional hepatitis are VHC. This situation motivated us to make a descriptive and transversal study in order to screen VHC in a group of patients who had been transfused with blood and/or haemoderivates. The patients came from the medical doctor's office N(o) 36 belonging the polyclinic "19 de April", in the city of Havana. The objective was to study the prevalence of the virus in our area and also to precise the main causes of the transfusion and the relationship between their number and the presence of anti-HVC. We found 35 patients who had been transfused (5.3 per cent) in the population (653), and from these, three patients (8.5 per cent) were anti-HVC positive. The main cause for having been transfused was anemia, being sicklemia the entity, which reported more patients with anti VHC positive. We also conclude that the probability of having an anti-HVC positive increases proportionally to the number of transfusions; these were significant differences between the groups who received a greater and a smaller number of transfusions.

The seroprevalence of hepatitis B and C in an Amerindian population in the southwestern Brazilian Amazon

A soroprevalência de hepatite B e C foi investigada na comunidade indígena Karitiana (n = 119), que habita o Estado de Rondônia, Amazônia Ocidental Brasileira. A prevalência de anticorpos anti-HBs e anti-HBc foi respectivamenre de 16,1 por cento e 35,3 por cento, sendo detectado HBsAg em somente quatro (3,4 por cento) indivíduos. Anticorpos anti-HCV foram encontrados em dois (1,7 por cento), indivíduos. Os dados estratificados por idade sugerem que tanto as vias de transmissäo vertical como horizontal (esta entre adultos) säo importantes nesta comunidade

Prevalence of hepatitis G and associated HBs Ag HCV -Ab viral markers among professional blood donors/drug addicts in Pakistan

Hepatitis B and C viral infections have been prevalent with endemicity throughout the world including Pakistan. In Pakistan no information is yet available about the prevalence of hepatitis G virus in general population and high risk groups. On a small scale some work was done [in collaboration with Nagoya University, Japan], with reference to the prevalence of hepatitis B and C viral infection in different risk groups. The present study pertains to 474 individuals [representing professional blood donors and drug addicts] in order to find out the prevalence of HGV status in Pakistan. Seven [1.5 percent] individuals were screened as hepatitis G virus RNA positive by PCR technique. Interestingly, two of these individuals were found to have co-infection with hepatitis C virus based on HCV-Ab, another two of them were found to have mixed infection with hepatitis B and hepatitis C viruses, while rest of the three were exclusively infected with HGV. This suggests for a thorough screening [including HGV] of all blood donors even if their routine hepatitis profile is negative

Anti HCV en pacientes hemodializados: descenso de la prevalencia y asociación con variables epidemiológicas / Anti HCV in hemodialyzed patients: reduction of the prevalence and association with epidemiological variables

Para estabelecer la prevalencia actual de infección por HCV en pacientes hemodializados (HD) de la ciudad de La Plata y determinar su asociación con diferentes variables se estudiaron 217 pacientes con Insuficiencia Renal Crónica de una Unidad de Hemodiálisis de un Htal público y de 7 Unidades del medio asistencial privado. En la totalidad de los pacientes se investigó la presencia sérica de anti-HCV y de anti-HBc y se valoró la edad, sexo, número de transfusiones, antigüedad del tratamiento hemodialítico, uso de eritropoyetina y episodios de hepatitis. Se halló una prevalencia de anti-HCV del 18,4 por ciento significativamente superior a la de los donantes de sangre (P<0,01) y significativamente enor a la hallada en pacientes HD de la misma ciudad en 1993 (P=0,002). También se encontró que la presencia de anti-HCV se asocia con el antecedente de haber recibido transfusiones y con mayor tiempo de ento hemodialítico. Nuestro resultados parecen coincidir con los que sugieren que las aminotransferasas en pacientes HD anti HCV © son un mal marcador de lesión hepatocelular.

Prevalencia de HCV y HBV en pacientes pediatricos hemodializados: estudio multicentrico / HCV and HBV prevalence in hemodialyzed pediatric patients: multicenter study

Los pacientes Hd constituyen una población de riesgo para la infección por los virus de las hepatitis B y C. El objetivo de este trabajo fue evaluar la prevalencia de la infección por HCV y HBV en un corte de una población de niños hemodializados. Se estudiaron 61 pacientes pediátricos en hemodiálisis, 12 de los cuales eran Tx, con edades comprendidas entre 2 y 20 años (media: 12,9), 23 varones y 38 mujeres. Se determinaron los anticuerps anti-HCV IgG por enzimoinmunoensayo (EIE) (Abbott 2 generación) y como método confirmatorio se utilizó inmunoblotting de péptidos sintéticos linearizados (LIA-TEK) (Organon). La detección de los marcadores para HBV fue por EIE y el nivel de actividad de las transaminasas se determinó por método cintético. El 19,7 por ciento de los niños estudiados fueron HCV positivos y el 29,5 por ciento fueron HBV positivos, de los cuales el 38,9 por ciento fueron HBsAg positivos el 50 por ciento Anti-HBs positivos. La infección por HCV y HBV se vió incrementada en relación al número de transfusiones y al tiempo de inclusión en Hd. La elevación de nivel de actividad de las transaminasas no fue un buen índice de infección para HBV y HCV en estos pacientes.

Genotipo del virus C de la hepatitis en pacientes con porfiria cutanea tarda / Genotype of the hepatitis virus C in patients with porphyria cutanea tarda

En pacientes con porfiria cutánea tarda (PCT) se ha demostrado alta prevalencia del anticuerpo del virus C de la hepatitis (anti-VCH) y del propio virus. Previamente hemos informado una prevalencia de anti-VCH de 53 por ciento, y de 80 por ciento entre aquellos pacientes con PCT esporádica. La PCT se asocia frecuentemente a daño hepático crónico,desconociéndose su origen. Se ha postulado que el VCH, directa o imdirectamente, modificaría la actividad de la uroporfirinógeno decarboxilasa(URO-D) hepática, alteración carterística de la PCT, y por lo tanto la enfermedad sería adquirida y no genética. Podría esperarse que la frecuencia e intensidad de la hepatopatías en los pacientes con PCT fuera mayor en aquellos pacientes portadores del Anti-VCH

Problematica de la infeccion por el virus de la hepatitis C en donantes de sangre: evaluacion clinico-epidemiologica, virologica e histologica / The problem of hepatitis C virus infection in blood donors: clinico-epidemiological, virological and histological evaluation

El objetivo fue establecer prospectivamente el significado clínico de la infección por el virus de la hepatitis C (HCV) en donantes voluntarios de sangre. Fueron evaluados 248 donantes de acuerdo al resultado definitivo del anti-HCV, analizándose los factores de riesgo, niveles de transaminasas (ALT), ARN del virus C por PCR y biopsia hepática. De los 248 donantes 132 (53,22 por ciento) resultaron verdaderos anti-HCV+ y 116 (46,77 por ciento) anti-HCV(-), 198 eran hombres y 50 mujeres, edad promedio 33,4 años. Factores de riesgo en el grupo anti-HCV+: drogadición intravenosa (22 por cento vs 1,72 por ciento) (p 0,0000), cirugía mayor (20,4 por ciento vs 12 por ciento), tatuajes (12,1 por ciento vs 4,3 por ciento), consumo de drogas no endovenosas (17,4 vs 4,3 por ciento) ( p 0,001) y promiscuidad sexual o enfermedades de transmisión sexual (25,7 por ciento vs 11,2) (p 0,003). En el grupo anti-HCV+ se encontró por lo menos un factor de riesgo en el 76,5 por ciento de los casos vs un 34,4 por ciento en el grupo anti-HCV(-) (p 0,000). Aceptaron biopsia hepática 71 donantes HCV(+) y el 69 por ciento (49 pts) presentó ALT elevadas. El 85,9 por ciento (61) de los pts. presentó hepatitis crónica, el 11,2 por ciento (8) hallazgos mínimos incaracterísticos 11,2 por ciento (8) y el 2,8 por ciento (2) hepatitis aguda. El 76 por ciento (54) de los pts. fueron PCR-HCV(+). El promedio del score de Knodell fue 6,75 (DS 3,51). En conclusión, en el 76,5 por ciento de los donantes (HCV(+) se encontró por lo menos un factor de riesgo (22 por ciento de antecedentes de DIV); el 85,9 por ciento presentó lesiones crónicas en la biopsia independientemente de los niveles de transaminasas y la presencia de ALT normal no excluyó lesión hepática.