[Clinical characteristics of 638 patients infected with hepatitis C virus by post blood transfusion, in Shanghai].

OBJECTIVE: To investigate the clinical-epidemiologic characteristics of patients with hepatitis C virus (HCV) infection by post blood transfusion. METHODS: Polymerase chain reaction (PCR) and enzyme linked immunosorbent assay (ELISA) were used to detect HCV RNA and anti-HCV, respectively. Analysis was performed on patients' age distribution, cause of primary diseases, years of exposure, ingredient and amount of transfusion, incubation period, disorder on liver function and changes on abdominal ultrasound image, etc. RESULTS: HCV RNA levels were higher than 3.0 log(10) copy/ml in 90.8% infected patients with a median as 6.10 log(10) copy/ml. 19.2% of the patients showed viral load 3.0 to 4.0 log(10) copy/ml, and 66.1% of them showed 5.0 to 6.0 log(10) copy/ml. Only 14.7% of the infected persons had HCV RNA levels higher than 7.0 log(10) copy/ml. Eighty-one point five percent (44/54) of the infected persons were confirmed as HCV RNA positive by HCV RNA qualitative analysis with HCV genotype as primarily type 1. 99.8% (636/637) of the patients were detected as anti-HCV positive by serological test. The sensitivity of serological test was higher than both quantitative and qualitative HCV RNA assays (P = 0.000, P = 0.000, respectively). HCV infection post blood transfusion was more seen in common people at 40 to 60 years old. Most cases (85.7%) had their first exposure during 1990 to 1994. More than 10% of the cases had primary diseases as obstetrics, orthopedics or gastrointestinal tract hemorrhage. 79.9% of the patients received whole blood product transfusion. The mean interval between transfusion and clinical diagnosis was 8.5 ± 5.5 years. 90.1% of the infected patients had liver function damage, while most of them showed elevated alanine aminotransferase (ALT) no more than 5 upper limits of normal (ULN), whereas Serum total bilirubin (TBIL), ALT and aspartate aminotransferase (AST) ≥ 5 × ULN level were showing more clinical manifestations (P = 0.000, P = 0.001, P = 0.009, respectively). Abdominal ultrasound among 8.9% of the infected persons showed changes in cirrhosis, and most of them were older than 50 years of age. CONCLUSION: Most of the post transfusion HCV infected cases happened in adulthood, and were mainly exposed during 1990 to 1994. Infected patients usually had their liver function damaged with elevated ALT no more than 5 × ULN and with medium HCV RNA levels. HCV genotype was mainly for type 1. Patients who were of older age showed higher incidence of cirrhosis. If a patients' infection period was longer than 5 years, he/she would show higher incidence of cirrhosis.

The relationship between staging of hepatic fibrosis and the levels of serum biochemistry.

OBJECTIVE: To study the relationship between the degree of hepatic fibrosis and serum fibrosis markers. METHODS: Liver biopsies were performed in 67 patients with hepatitis. The sections were stained with hematoxylin eosin and immunohistochemical stain. Staging of hepatic fibrosis was made microscopically. The serum levels of hyaluronic acid(HA), type III procollagen(PC-III), laminin(LN), and type IV collagen (IV-C) were measured by radioimmunoassay. RESULTS: The serum levels of HA, PC-III, LN and IV-C were elevated from S1 to S4 because of the increase of hepatic fibrosis. The serum concentrations of HA, PC-III, LN and IV-C were increased with the progress of disease, with the highest concentration at the stage of cirrhosis. CONCLUSION: The stages of hepatic fibrosis are correlated with the serum levels of HA, PC-III, LN and IV-C, which as markers may play a role in detecting the degree of hepatic fibrosis.