Hepatitis B virus,hepatitis C virus

Medical workers should have anti-HBV antibody to protect HBV infection in the hospital. If they have not anti-HBV antibody, they should receive HBV vaccination. HBV vaccination program is as follows: 10 micrograms, s.c., 0, 1, 6 months. In case of HBV contamination, 1,000 IU hepatitis B immune globulin(HBIG) and/or 10 micrograms HB vaccine should be administered judging from HBV markers of contaminated subjects and HBV load of patients. The HCV vaccine is not available. In case of HCV contamination, it is unnecessary to treat just after accident. If acute hepatitis C is evolved in those subjects during follow-up, it is recommended to treat with interferon. Eradication of HCV by interferon among patients with acute hepatitis C will be almost 100%.     

Residual risk of transfusion-transmitted human immunodeficiency virus, hepatitis C virus, and hepatitis B virus infections in Italy

BACKGROUND: Estimating the risk of transfusion-transmitted infections (TTIs) is essential for monitoring blood safety. The residual risk of TTI was estimated for nearly 90 percent of the blood supply in Italy. STUDY DESIGN AND METHODS: Data were analyzed from 1,079,281 repeat donors, corresponding to 5,361,000 donations made in blood transfusion centers throughout Italy in the period 1999 through 2001. The residual risk of transfusion-transmitted human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV) infections was estimated with the incidence rate-window period model. The denominator for the incidence rate (i.e., the number of person-years at risk) was estimated on a sample of 5850 donors. RESULTS: The risk of an infectious donation entering the blood supply, per 1 million donations, was 1.91 (probable range, 0.52-3.32) for HIV, 16.74 (9.57-24.01) for HCV, and 69.16 (43.12-102.70) for total HBV (adjusted for vaccination and hepatitis B surface antigen transience). CONCLUSION: In Italy, the estimated residual risk of TTI is apparently low, particularly for HIV infection. Although the estimated risks are higher for HCV and HBV, the introduction of mandatory viral detection tests for HCV in 2002 should account for an 80 percent reduction in the HCV risk. Moreover, the ongoing HBV vaccination program will contribute to reducing the risk of transfusion-transmitted HBV.     

Neopterin levels during the early phase of human immunodeficiency virus, hepatitis C virus, or hepatitis B virus infection

BACKGROUND: A study was conducted to assess the diagnostic sensitivity of neopterin screening of blood donors with regard to the detection of window-phase specimens of human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV) infection. STUDY DESIGN AND METHODS: In total, 1002 diagnostic window-phase specimens from 98 seroconversion panels (29 HIV-1, 52 HCV, and 17 HBV) were analyzed with viral antigen detection, viral nucleic acid amplification testing (NAT), and neopterin quantitation assays. The study was completed by the analysis of 92 anti-hepatitis B core antigen (HBc)-reactive and 103 alanine aminotransferase (ALT)-elevated blood donor specimens. RESULTS: A significant association between elevated neopterin concentrations and the very early phase of HIV-1 infection was found. No significant correlation could be observed between neopterin levels and the early phase of HCV or HBV infection. Neopterin concentration was not increased in specimens from blood donors with anti-HBc reactivity or ALT elevation. CONCLUSIONS: Neopterin screening of blood donors may identify window-phase cases of HIV, but not of HCV or HBV infection. The diagnostic sensitivity of neopterin screening during the HIV window phase is similar to that of the p24 antigen test. With the introduction of viral NATs in blood screening, there is no additional benefit of neopterin screening with regard to the three blood-borne viruses HIV, HCV, and HBV. Acute phases of other infectious agents, however, have been reported to be detected by neopterin enzyme-linked immunosorbent assays.     

Risk factors and seroprevalence of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus infection in uzbekistan.

OBJECTIVES: The aim of this study was to elucidate the seroprevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infection in Uzbekistan and to explore whether there is a correlation between those blood-borne agents and socioeconomic risk factors. METHODS: One thousand nine hundred and eighteen subjects were studied. The subjects were divided into a low-risk group, a high-risk group and a patient group. Sera were tested for HBV surface antigen (HBsAg), anti-HCV, and anti-HIV. RESULTS: The seroprevalence of HBsAg, anti-HCV, and anti-HIV in the general population was 13.3, 13.1 and 0%, respectively. The anti-HCV infection rate was significantly higher in intravenous drug users (62.7%) than in prostitutes (9.2%), homosexuals (11.1%), and medical laboratory employees (12.5%) (p < 0.01). In the low-risk group, positivity for anti-HCV increased with age from 2.2% in the 15- to 20-year-olds up to the highest rate of 17.6% in the 31- to 40-year-olds; the positivity then decreased to 0% in the group over 60 years of age. In the high-risk group, the positivity for anti-HCV in the age groups under 40 years was approximately 30% and significantly higher than in the low-risk group (p < 0.01). Risk factors for transmission of HCV were medical treatment in the low-risk group, drug abuse in the high-risk group, and both in the patient group. CONCLUSIONS: This study demonstrates that the seroprevalence of HBV and HCV infection is high, whereas HIV infection is yet uncommon in Uzbekistan.     

Prevalence and trends of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus among blood donors in Iran, 2004 through 2007

BACKGROUND: Evaluation and monitoring the prevalence of transfusion-transmissible viral infections in blood donors is a valuable index of donor selection and blood safety. This study analyzed the trends of blood-borne infections among Iranian blood donations during 4 years.
STUDY DESIGN AND METHODS: Viral screening results of 6,499,851 allogeneic donations from 2004 through 2007 were analyzed. All donations were screened for hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and syphilis. The prevalence of HBV, HCV, and HIV infections per 100,000 donations and 95% confidence interval was calculated. The p value was estimated by chi-square test.
RESULTS: The prevalences of HBV, HCV, and HIV decreased during the 4-year study from 2004 through 2007. The overall prevalence was 0.56% for HBV, 0.004% for HIV, and 0.13% for HCV. There was a significant and impressive decrease in hepatitis B surface antigen prevalence from 0.73% in 2004 to 0.41% in 2007. The prevalence of HIV appeared to have decreased from 0.005% in 2004 to 0.004% in 2007 although the decrease was not significant. HCV prevalence showed a slight decline in blood donations from 0.14% in 2005 to 0.12% in 2007.
CONCLUSION: The trends of transfusion-transmitted infection prevalence in Iranian blood donations suggest that most of the safety measures employed in recent years in Iran have been effective.     

Prevalence and risk factors of hepatitis C virus, hepatitis B virus, and human immunodeficiency virus in multiply transfused recipients in Mexico

BACKGROUND: Transfusion-transmitted viral infection (TTI) is a major problem in patients receiving blood products. Monitoring high-risk patients is essential for assessing the epidemiology of blood-borne infections.
STUDY DESIGN AND METHODS: A 1-year, cross-sectional seroprevalence study in patients with a history of multiple transfusions was conducted. Peripheral blood samples were titered to detect serologic markers of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). The presence of these viruses and demographic, behavioral, and medical traits were assessed.
RESULTS: A total of 300 male and female multiply transfused patients with a mean age of 30.7 (±17.5) years were studied. The prevalence was 13.7% for HCV, 7% for HBV, and 1.7% for HIV. Patients with hemophilia had the highest prevalence for HCV and HIV infections, and hemodialyzed patients, for HBV infection. The risk factors related to acquired HCV were hemophilia (odds ratio [OR], 5.6; 95% confidence interval [CI], 2.5-12.6), more than five hospitalizations (OR, 3.8; 95% CI, 1.6-8.9), and having received a transfusion before mandatory screening in 1993 (OR, 8.4; 95% CI, 2.0-34.6), and for HIV, having received a transfusion before 1987 (OR, 19.0; 95% CI, 2.0-177.7). The main risk factors for HBV were having end-stage renal disease and being treated with hemodialysis (OR, 3.7; 95% CI, 1.4-9.9) and transplantation (OR, 4.2; 95% CI, 1.4-12.1).
CONCLUSIONS: This study showed that HCV infection was more frequently identified than HBV and HIV infections in multiply transfused Mexican patients. Additionally, several risk factors are associated with TTI such as mandatory screenings before 1987 and 1993, which were the most important for HIV and HCV infections but not for HBV.     

Mini-pool screening by nucleic acid testing for hepatitis B virus, hepatitis C virus, and HIV: preliminary results

BACKGROUND: The purpose of this study was to evaluate the feasibility of nucleic acid testing (NAT) of mini-pools as a blood donation screening test. STUDY DESIGN AND METHODS: The stepwise implementation of NAT of mini-pools began in January 1997. Since March 1997, all blood donations collected by the German Red Cross Blood Transfusion Service of Baden-Wurttemberg were tested for hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV nucleic acids. An extra barcoded serum sample is collected from each blood donor for NAT-based screening, which is performed only on hepatitis B surface antigen-, anti-HCV-, anti-HIV-, and anti-Treponema pallidum-seronegative donations. Samples are pooled to a maximum of 96. Positive results are resolved through intersecting subpools (a chessboard design). NAT-based screening does not include a virus concentration step before nucleic acid extraction. RESULTS: By the end of October 1997, 331, 783 donations in 3,779 pools had been screened. As yet, no viremic but seronegative blood donor has been found for the three markers. CONCLUSION: It is feasible to incorporate NAT-based screening of mini-pools into the routine virus diagnostics of a large blood transfusion service. It remains to be determined whether screening blood donations by NAT will indeed increase the safety of blood supply.     

丙型病毒性肝炎病毒基因型与病毒载量及疾病进展的相关性分析

目的 分析丙型病毒性肝炎(丙肝)病毒(HCV)的基因型与病毒载量及肝脏疾病进展的相关性. 方法 选择2010年12月至2013年4月在宁波市第二医院北郊院区就诊的慢性HCV感染者,分别采用反转录-聚合酶链反应(RT-PCR)法和基因芯片法检测HCV RNA和HCV基因型. 结果 107例标本中,共检出7种亚型,其中1a型4例(3.74%),1b型52例(48.60%),2a型15例(14.02%),3a型10例(9.35%),3b型9例(8.41%),6型16例(14.95%),1b+2a混合型1例(0.93%);男女慢性HCV感染均以1型为主要基因型,但男性6型的构成比高于女性(2=4.336,P=0.049);各年龄组间HCV基因型的构成及各基因型的年龄构成差异均无统计学意义;6型的病毒载量最高,其次为1型,2、3型的病毒载量明显低于6型和1型(P0.01);终末期肝病患者和伴存免疫缺陷患者的病毒载量均高于慢性丙肝患者,且终末期肝病患者以基因1型(主要为1b)为主(P=0.016). 结论 本地区HCV基因型同样以1b型为主,且1b型感染者的病毒载量较高,疾病进展较快;6型的感染率较高,应重视对基因6型HCV感染者的研究.     

Blood screening for non-A, non-B hepatitis by hepatitis C virus antibody assay

Hepatitis C virus (HCV) antibody was detected in 1499 donor sera by radioimmunoassay using an antigen expressed in yeast from a cDNA clone of the HCV genome. Eighteen samples over 4200 counts per minute (cpm) were considered to contain infectious HCV because these recipients developed typical posttransfusion non-A, non-B hepatitis after transfusion. The antibody-positive sera were all within the normal range of ALT levels. This assay system is thus useful for the screening for blood transfusion.     

One-year experience of nucleic acid technology testing for human immunodeficiency virus Type 1, hepatitis C virus, and hepatitis B virus in Thai blood donations

BACKGROUND: Blood donations collected at the National Blood Center, the Thai Red Cross Society, Bangkok, in 2007 were tested by nucleic acid amplification technology (NAT) using the Chiron TIGRIS/Procleix Ultrio test and the Roche cobas s 201/cobas TaqScreen multiplex (MPX) test.
STUDY DESIGN AND METHODS: The sensitivity, specificity, and robustness were determined by testing 486,676 seronegative blood donations. Samples from each day of collection were divided into two sets; the odd-numbered samples were tested individually on the TIGRIS and the even-numbered samples were tested in pools of 6 on the cobas s 201. The status of reactive samples was confirmed by duplicate testing of samples from the plasma bag to calculate the test specificity. Reactive samples were tested on the alternate system and followed up.
RESULTS: The analytical sensitivity of both systems met the 95% limits of detection claimed by the respective package inserts. No cross contamination was seen with either system. Test specificity was 99.93 and 99.90% for the Procleix Ultrio and cobas TaqScreen tests, respectively. The NAT yield rates for human immunodeficiency virus Type 1 (HIV-1), hepatitis C virus (HCV), and hepatitis B virus (HBV) were 1:97,000, 1:490,000, and 1:2800, respectively. Several occult HBV donors, the majority of whom were detected by both tests, were also identified. The HIV-1 and HCV window cases were detected with both tests.
CONCLUSION: The performances of the systems and tests indicated that both were acceptable for routine NAT by the National Blood Center, the Thai Red Cross Society. However, the Procleix Ultrio test appeared to be less sensitive than the cobas TaqScreen test for HBV.     

Prevention of mother-to-child transmission of hepatitis B virus and hepatitis C virus

About 240 million people worldwide are chronically infected with hepatitis B virus (HBV). Vertical transmission is the most important mechanism of infection persistence in endemic areas. About 150 million people worldwide are chronically infected with hepatitis C virus (HCV). Mother-to-child transmission of HCV, which occurs in 3–10% of cases, is the leading route of infection in childhood. This review focuses on strategies to reduce the vertical transmission of HBV and HCV. The at-birth prophylaxis of newborns of HBV-infected mothers with specific immunoglobulin and vaccine plus administration of antivirals (tenofovir or telbivudine) in the third trimester of pregnancy (in case of high maternal viral load) greatly reduces the risk of transmission. In contrast, currently there is no drug able to reduce the vertical transmission of HCV infection. We discuss the possibility of reducing mother-to-child HCV transmission using newly available antivirals or antivirals in the pipeline for the treatment of hepatitis C.     

No-fault compensation for transfusion-associated hepatitis B virus, hepatitis C virus, and HIV infection: Italian law and the Tuscan experience

BACKGROUND: On February 25, 1992, in Italy, a law (Number 210; referred to as 210/1992) was promulgated providing economic indemnity for persons infected with hepatitis B virus, hepatitis C virus, and HIV via transfusion or the administration of hemoderivatives. STUDY DESIGN AND METHODS: The requests for compensation presented in the central Italian region of Tuscany from the time of the law's promulgation through December 31, 1996, were analyzed. These requests are surveyed by medical commissions in the regional military hospitals, which must compile a report of the completed assessments, formulate a decision concerning verified illnesses, and express an opinion on the existence of a relationship of causality between the damaging event and the impairment or death of the subjects. RESULTS: Out of 428 requests for indemnity, 372 have been granted and 56 denied. Posttransfusion infections (286 cases) were clearly more prevalent than those due to hemoderivatives (141 cases). Cases of hepatitis, particularly type C, constitute the great majority of the infections for which indemnity was sought, while cases of HIV infection are scarce and in sharp decrease in the data from 1995 and 1996. CONCLUSIONS: Italian Law 210/1992 has been recognized as providing a benefit to persons infected medically, but its efficiency is greatly obstructed by a lack of documentation regarding transfusions performed in the past.     

Biochemically silent posttransfusion non-A, non-B hepatitis interferes with superinfection by hepatitis A virus

Superinfection of a silently non-A, non-B (NANB)-infected chimpanzee with hepatitis A virus (HAV) resulted in minimal liver enzyme elevations, lack of detectable HAV in stool, and questionable presence of HAV antigen in liver biopsy specimens obtained during the expected period of virus replication. Our findings indicate that even biochemically silent NANB hepatitis can strongly interfere with infection by at least one other hepatotrophic virus.     

环介导的等温扩增技术对HBV、HCV和HIV核酸检测的研究

目的建立环介导的等温扩增技术(LAMP)对HBV、HCV和H IV核酸检测的方法并对检测灵敏度和特异性作初步考核。方法通过引物设计和筛选、内质控的设计与时间分辨浊度检测方法的运用,建立LAMP HBVDNA、HCV RNA和H IV RNA扩增体系;用连续稀释的阳性样本和不含任何病毒核酸的正常人血浆考核所建立的LAMP扩增体系的灵敏度和特异性。结果建立了LAMP HBV DNA扩增体系及HCV/H IV RNA双联检体系,该体系对5 CP/m l的HBV DNA样本的检出率为51.85%,对100 CP/m l的HCV RNA阳性样本的检出率为61.90%,对100 CP/m l的H IV RNA阳性样本的检出率为45%。对考核样本检测的相对灵敏度和特异性均为100%。结论LAMP HBV、HCV和H IV检测灵敏度较高,在进一步优化以后能用于HBV、HCV和H IV的核酸检测。