ABSTRACT
Hepatitis C virus (HCV) infection is highly prevalent in haemodialysis patients. To date, only a few studies involving a small number of subjects have characterized HCV-infected dialysis patients by serotyping. The spread of HCV serotypes in 114 HCV-positive dialysis patients from the same geographical area was evaluated by Murex HCV serotyping assay. Serotypes were detected in 102 subjects (89.5%), with type 1 being the most frequent (37.7%), followed by types 2 (19.3%), 4 (8.8%) and 3 (7.9%). Types 5 and 6 were the least prevalent (3.5%). Ten samples (8.8%) revealed mixed infections: type 1 was detectable in all and the co-infecting HCV types were types 2, 3 and 4 in 3, 4 and 3 cases, respectively. These results suggest that the serotyping assay as an alternative method of distinguishing the major types of HCV, also for particular risk groups and especially in laboratories that lack the specific expertise to perform genotyping methods. Age-related differences in patients with type 5 compared with those with types 3 and 6 may provide evidence of a more recent spread of these latter types.
Subject(s)
Hepacivirus/classification , Hepatitis C Antibodies/blood , Hepatitis C, Chronic/virology , Renal Dialysis , Adult , Aged , Aged, 80 and over , Cohort Studies , Enzyme-Linked Immunosorbent Assay , Female , Hepatitis C, Chronic/blood , Hepatitis C, Chronic/epidemiology , Humans , Immunoblotting , Italy/epidemiology , Male , Middle Aged , Prevalence , SerotypingABSTRACT
In order to evaluate hepatitis C virus-RNA (HCV-RNA), immunoglobulin M (IgM) anti-HCV and risk factors in haemodialysis patients, 180 subjects (45 HCV negative and 135 HCV positive) were studied. Sex, age, duration of dialysis, number of transfusions and ALT were also considered. HCV-RNA was determined by the Amplicor HCV test, and IgM anti-HCV by the Abbott HCV IgM EIA. These markers were present in 40% and 30.4% of anti-HCV positive subjects. The agreement between the two tests employed was 77%. The results showed a close association between HCV-RNA and IgM anti-HCV with abnormal ALT levels and between HCV-RNA and the number of transfusions. Both of these markers were different when correlated with age and time on dialysis, respectively. Therefore, IgM anti-HCV may also serve as a serological marker of HCV infection and a complementary marker of virus replication.
Subject(s)
Hepacivirus/isolation & purification , Hepatitis C Antibodies/blood , Immunoglobulin M/blood , Renal Dialysis , Adult , Aged , Biomarkers/blood , Blood Transfusion , Enzyme-Linked Immunosorbent Assay , Female , Hepacivirus/genetics , Hepacivirus/immunology , Hepatitis C/epidemiology , Humans , Male , Middle Aged , Polymerase Chain Reaction , Prevalence , RNA, Messenger/blood , RNA, Viral/blood , Risk Factors , Transaminases/bloodABSTRACT
In order to evaluate the sensitivity of HCV test, Ortho Second and Third Generation HCV Elisa Tests were used in 315 sera collected from dialysis patients. The agreement between the two tests was 96.5%. RIBA Second and Third generation and PCR were tested in the eleven discordant sera and in specimens collected in 1992 from the same patients and in 20 Ortho-2 and Ortho-3 HCV negative patients. Ortho-3 test is capable of detecting anti-HCV seroconversion earlier than Ortho-2 with increased sensitivity and specificity, as is confirmed by RIBA and PCR tests.
Subject(s)
Enzyme-Linked Immunosorbent Assay , Hepacivirus/isolation & purification , Renal Dialysis , Humans , Polymerase Chain Reaction , RNA, Viral/blood , Retrospective Studies , Risk Factors , Sensitivity and SpecificityABSTRACT
Plasma exchange (PE) was performed in 8 of 14 patients with systemic lupus erythematosus (SLE) PE was instituted as an additional therapy during active disease in patients who did not respond to conventional therapy. The best results were obtained in plasmapherized patients; in fact, immune complex serum levels disappeared rapidly, whereas anti-DNA antibodies decreased slowly. The changes observed indicate that PE may be beneficial, especially when it is associated with drugs that can block antibody rebound. A variety of "technical factors" may influence PE therapy which therefore must be monitored appropriately.
Subject(s)
Lupus Erythematosus, Systemic/therapy , Plasma Exchange , Adrenal Cortex Hormones/therapeutic use , Adult , Antibodies/analysis , Antibodies/immunology , Antigen-Antibody Complex/analysis , Antigen-Antibody Complex/immunology , Child , DNA/immunology , Glomerulonephritis/complications , Humans , Immunosuppressive Agents/therapeutic use , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/drug therapy , Lupus Erythematosus, Systemic/immunology , Middle AgedABSTRACT
Plasma-exchange was used in 10 patients with mixed cryoglobulinemia. The procedure was used as a primary therapeutic tool to reduce cryoglobulin levels, and in combination with prednisone and cytotoxic drugs. The results show that PE alone is detrimental, although it may be an important adjunct to conventional therapy in MCG with progressive deterioration in the clinical condition, and in those patients who do not respond to drug therapy alone. The weak response to PE in MCG may be due to many technical variables, but mainly to the low percentage of circulating cryoglobulins removed.
