Hepatitis C virus infection: other biological fluids than blood may be responsible for intrafamilial spread.

BACKGROUND/AIMS: Several epidemiological studies have shown the existence of other routes of transmission of the hepatitis C virus besides the parenteral one, but the mechanisms involved are not yet understood. The general aim of this study was to evaluate the prevalence of hepatitis C virus infection in family contacts of infected patients and to analyze the possible risk factors and alternative transmission routes. METHODOLOGY: One hundred and thirty-eight relatives of 45 patients (index cases) affected by C virus-related chronic hepatitis were studied. The relatives were 45 spouses, 89 children and 4 cohabitants who underwent detection of serum anti-HCV antibodies; the anti-HCV-positive subjects were tested for serum HCV-RNA. The index cases, all the spouses and only other infected relatives were tested for the presence of HCV-RNA in saliva RESULTS: Antibodies to hepatitis C virus were detected in 5.7% of the family members while 11.1% of the analyzed spouses were serum HCV-RNA-positive. HCV-RNA was found in 44% of the examined saliva and 39% of these were found serum HCV-RNA-negative. The prevalence of hepatitis C virus among household contacts, excluding cases with previous parenteral exposure, was 3.6%. CONCLUSIONS: The epidemiological data on the intrafamilial spread of hepatitis C virus may be underestimated owing to the existence of infected relatives serum-negative but saliva-positive for the presence of the virus. The whole of these observations suggests a possible role of biological fluids in intrafamilial spread of hepatitis C virus.

Spontaneous intrahepatic portosystemic venous shunt in a patient with cirrhosis: diagnosis by combined color Doppler and pulsed Doppler ultrasonography.

Large spontaneous intrahepatic portosystemic venous shunts are occasionally found and their diagnosis by Doppler sonography is rarely reported. The authors describe a case of spontaneous intrahepatic porto-systemic venous shunt in liver cirrhosis diagnosed by color Doppler and characterized by an unusual pulsed Doppler spectrum: a continuous flat portal-like pattern of flow in the portal branch, and in both the shunt and the hepatic vein.

Doppler ultrasound findings in Osler-Weber-Rendu disease with hepatic involvement: a case report.

A case of Osler-Weber-Rendu disease or hereditary haemorrhagic telangiectasia with hepatic involvement diagnosed by Doppler ultrasound is described showing an increased blood flow within the dilated common hepatic artery and multiple aneurysms of the intraparenchymal branches of the proper hepatic artery. Doppler ultrasound provides findings suggestive of hepatic involvement in this rare disease and allows invasive imaging studies to be avoided.