[Diagnostic strategies in Hepatitis C virus infection]. / Strategii diagnostice în infectia cu virusul hepatitei C.

Hepatitis C virus (HCV) is the most common cause of chronic viral hepatitis. The World Health Organization estimates that 170 million people world-wide are infected with HCV; 70% of them will develop chronic hepatitis and 20-30% cirrhosis in 10-30 years. Of those with cirrhosis, an estimated 25-30% will develop liver cancer. Since the identification and molecular characterization of HCV in 1989, a variety of diagnostic tests based on the detection of hepatitis virus antibodies or HCV RNA in the serum have been developed. The enzyme-linked immunosorbent assays (ELISA 3) and the recombinant immunoblot assays (RIBA 2nd and 3rd generation) exhibit improved sensitivity and specificity for HCV antibodies. Qualitative and quantitative reverse-transcriptase polymerase chain reaction (RT-PCR) has allowed clinicians to track the natural history of HCV and to monitor the progress of therapy. This article reviews the state-of-the-art tests and assays developed for the diagnosis and management of HCV infection.

[The specific serological profile in hepatitis B virus infection in children]. / Profil serologic particular în infectia cu virusul hepatitei B la copii.

UNLABELLED: Hepatitis B virus infection (HBV) has a very well known specific serologic profile. In the last years the molecular biology methods reveal some "particular serological profiles" by genomic mutation. One particular profile consists in the absence of anti-HBc total antibodies simultaneously with the presence of HBsAg. Our tested group consists of 372 children aged 0.1 to 15 years. The presence of HBsAg was determined by ELISA "sandwich" and confirmed by neutralisation test. For HIV infection we used two ELISA tests (competitive and indirect) and the Western Blot test for confirmation. Of the total, there were 13 children HBsAg positive and without anti-HBc antibody (3.49% respectively), 7 of the 13 children (53.8%) were dystrophic and 4 were HIV positive (30.76%). From 372 cases, 104 were HBsAg positive (27.9%) and 53 (14.2%) of them had chronic hepatitis. CONCLUSIONS: 1. The particular serologic profile requires the testing of all serological markers specific for HBV. 2. This particular serologic profile is correlated with HIV positive status and dystrophy.

[The prevalence of anti-hepatitis C virus antibodies in children from social assistance units in the county of Iasi]. / Prevalenta anticorpilor anti-virus hepatitic C la copii din unitati de asistenta sociala din judetul Iasi.

UNLABELLED: The aim of this study was to determine the prevalence of anti-HCV antibody (Ab) in association with specific markers for hepatitis A virus (HAV) and hepatitis B virus (HBV). We investigated 127 children from two orphanages from Iasi District (77 males--60.6%). An ELISA kit, IInd generation (Diagnostic Pasteur) was used for anti-HCV determination. Hepatitis B surface antigen (HBsAg) and anti-HAV/total antibodies were diagnosed by ELISA competitive and "sandwich" type respectively (Wellcome-Murex). 16.8% from all children was "repeated reactive" for anti-HCV Ab test; majority of them (88.9%) had a positive result for anti-HAV/total Ab and 30.7% were "carriers" for HBsAg. IN CONCLUSION: (1) the prevalence of anti-HCV Ab is more than 3 fold, comparative with the 4.5% value from blood donors in our region; (2) the high level for HBsAg as marker for an HBV infection requires to test the children's liver function to select and monitor them for IFN treatment purposes; (3) for HAV, which is never involved in chronic infection, even if the vaccination is now available, the cost/benefit ration, suggests that the unspecific prevention methods still keep their value.

[The role of C-reactive protein (CRP) determination in the early diagnosis of infections with opportunistic microorganisms in HIV-infected children]. / Rolul dozarii proteinei C-reactive (CRP) în depistarea precoce a suprainfectiilor cu microorganisme conditionat patogene la copii HIV-infectati.

The levels of C-reactive protein (CRP) in sera of 71 HIV-seropositive children and of 71 apparently healthy children were determined by Mancini method. The results demonstrate that HIV-infection per se doesn't increase the concentration of CRP in serum. After this we wanted to determine the relationship between CRP and evolution of HIV-infection. For this we used a set of 8 children in different stages of HIV-infection. For each child we had at least 2 sera, used for diagnosis and CRP assay. Three children (one with AIDS [correction of SIDA] and 2 in intermediate stage) had elevated levels of CRP. The reason for these elevations were an acute salmonellosis, a febrile episode of unknown origin and for the last child, once a staphylococcal infection of the skin and once an acute bronchiolitis clinically but not microbiologically documented. In conclusion, HIV-infection per se doesn't induce increased levels of the CRP, in any stage; this protein could be used as a marker of bacterial, parasitic and cytomegalovirus infections.