Evaluation of the available anti-HCV antibody detection tests and RT-PCR assay in the diagnosis of hepatitis C virus infection.

The aim of the present work is to evaluate the commercially available antibody tests in the diagnosis of hepatitis C virus (HCV) infection by comparing their results with the RT-PCR test. The study included 316 serum samples from three groups: blood donors, patients on maintenance hemodialysis (HD) and patients infected with the human immunodeficiency virus (HIV). Samples were subjected to HCV-antibody detection by ELISA and RIBA tests and HCV-RNA detection by RT-PCR assay. The percentage of infectivity for blood donors was 18.9% by ELISA, 20.8% by RIBA and 23.6% by RT-PCR test. For patients on HD and those positive for HIV, the test positivity was respectively 59.3% and 5.3% by ELISA, 64% and 10.5% by RIBA and, 66.3% and 21% by PCR test. The percentage of false negativity of HCV-Ab by ELISA and RIBA when compared with RT-PCR test was 3.5 and 8.1% for samples blood donors, 17.1 and 25.7% for HD patients and 5.6 and 16.7% for HIV-infected samples, respectively. The false positivity of HCV-Ab by ELISA and RIBA, when compared with RT-PCR, was 5%, 3.9% and zero for blood donors, HD patients and HIV-HCV co-infected cases, respectively. While comparing ELISA with RT-PCR, the false positivity was 10%, 5.9% and zero respectively for blood donors, HD patients and HIV-HCV co-infected cases. Thus, it is very important to screen blood donors, HD patients and HIV-infected patients by using the RT-PCR for HCV-RNA to avoid false negative results.

Prevalence of gastroesophageal reflux disease in patients with laryngeal and voice disorders.

OBJECTIVE: To determine the prevalence of gastroesophageal reflux disease (GERD) for the management of patients with laryngeal and voice disorders. METHODS: This study consisted of 30 patients from Ear, Nose and Throat (ENT) and Phoniatric outpatient clinics at Al-Noor Specialist Hospital in Holy Makkah, Saudi Arabia complaining of laryngeal symptoms mainly dysphonia, during one year period from May 2005 to May 2006. All patients were subjected to: voice evaluation, which include searching for etiological factors, auditory perceptual assessment (APA), laryngeal examination and upper gastrointestinal tract (GIT) endoscopy. RESULTS: The onset of complaint of voice changes was gradual (93%), the duration was more than 6 months (90%) and the course was intermittent in 43% of patients. Phonasthenia symptoms were common. The change of voice was mainly due to high vocal demand (63.3%), tense temperament (93.3%) and spicy foods (60%). The grade of dysphonia was slight in 50% of patients, the characters of voice were mainly strained and leaky (76.7%) and the pitch was mainly decreasing (56.7%). Hyperfunctional dysphonia was present in 26.7% of patients, phonasthenia in 16.7%, vocal fold (VF) polyp in 13.3% and contact granuloma in 6.7%. Presence of GERD with hiatus hernia in 63.3% of patients, GERD with acute gastritis and duodenitis in 10% and incompetent lower esophagus in 6.67%. CONCLUSION: Laryngeal and voice disorders was mostly due to GERD in 80% of patients, which was mainly GERD with hiatus hernia.