[Familial transmission of hepatitis C virus]. / Transmission familiale du virus de l'hépatite C.

OBJECTIVES: The intrafamilial transmission of hepatitis C virus infection was assessed in the family members of patients with chronic hepatitis C. METHODS: The presence of serum anti-hepatitis C virus (HCV) antibodies and epidemiological features were studied in 193 relatives (104 heterosexual partners, 89 children) of 113 patients with chronic hepatitis C. The presence of serum anti-HCV antibodies was detected by an ELISA 2 test and confirmed by a RIBA 2 test. In all patients, liver injury was ascertained by biopsy (31 cirrhosis, 82 chronic active hepatitis). RESULTS: Eleven of 104 (10.6%) regular heterosexual partners were positive for anti-HCV antibodies. In 8 of these, risk factors were detected (drug addiction: n = 6, blood transfusion: n = 1, occupational exposure: n = 1). Only 3 of 96 (3.2%) regular heterosexual partners without percutaneous risk factors were positive for HCV. Among couples with heterosexual partners negative for anti-HCV antibodies, the mean duration of the sexual relationship was 12 years. Serum anti-HCV antibodies were present in 1 of 89 (1.1%) children without history of blood transfusion or drug addiction. None of the 35 children born after supposed maternal contamination were positive for serum anti-HCV antibodies. CONCLUSIONS: We conclude that the prevalence of serum anti-HCV antibodies, assessed with second generation tests, in sexual partners of patients with chronic hepatitis C, is lower than previously reported with first generation anti-HCV tests but higher than in the general population (3.2% vs approximately equal to 1%). Serum anti-HCV antibodies were very rarely detected in children from patients with chronic hepatitis C.

[The value of laparoscopy in the staging of digestive system cancers]. / Intérêt de la laparoscopie dans le bilan d'extension des cancers digestifs.

Sixty two patients with a gastrointestinal carcinoma were evaluated pre-operatively by ultrasonography, CT scan and laparoscopy to seek liver metastases and/or peritoneal carcinomatosis. Performance levels of laparoscopy, ultrasonography and CT scan were comparable regarding the diagnosis of liver metastases. Laparoscopy was markedly better than CT scan and ultrasonography in the diagnosis of peritoneal carcinomatosis. Thus the investigation of choice for the detection of liver metastases is a single imaging technique. In contrast, if excision surgery is envisaged, all gastrointestinal carcinomas should be assessed by ultrasonography and/or CT scan and laparoscopy to definitely eliminate peritoneal carcinomatosis or small superficial liver metastases, in such a way as to avoid unnecessary laparotomy.