Prevalence of hepatitis A virus antibodies in patients with chronic liver diseases.

OBJECTIVE: The age of persons with hepatitis A virus (HAV) infection in the general population has risen; these persons are at increased risk of clinically severe disease, especially patients with chronic liver disease. The aim of the present study was to analyze the prevalence of total antibodies against HAV in patients with chronic liver disease. METHODS: In a prospective study carried out between September 1998 and June 1999, 180 patients seen in the chronic liver disease outpatient department were studied. The prevalence of total anti-HAV antibodies was determined by age group, etiology and degree of histological damage, and according to the antecedents of risk for parenteral infection. A nonconditional logistic regression model was fitted with anti-HAV positivity as the dependent variable. RESULTS: Mean age was 44.1 years, with an anti-HAV prevalence of 77.2% (varying from 42.9% in the 21-25-year-old group to more than 83% in patients > 56-years old). Differences across groups regarding other categories (histological damage, etiology and history of parenteral or drug use) were not statistically significant, but the probability of anti-HAV positivity increased with age and a history of drug addiction. CONCLUSIONS: The prevalence of total anti-HAV antibodies is high among patients with chronic liver disease. We therefore recommend this test before vaccination against HAV, until current recommendations on universal childhood vaccination are implemented, in order to prevent hepatitis A epidemics in the general population.     

Prevalence of antibodies to hepatitis C virus among patients with cryptogenic chronic hepatitis and cirrhosis.

Many cases of chronic hepatitis and cirrhosis cannot be attributed to a known cause and are collectively referred to as cryptogenic chronic liver disease. We have evaluated the role of the hepatitis C virus in the pathogenesis of this condition in a retrospective serum analysis for antibody to hepatitis C virus in 129 patients with cryptogenic liver disease. Other causes of chronic hepatitis and cirrhosis were ruled out by clinical, serum biochemical and serological techniques. All 129 patients were HBcAg negative, but 28 (22%) had antibody to HBcAg. Sera were tested by radioimmunoassays using recombinant peptides for antibodies to nonstructural (C100-3 and C33c) and structural regions (C22) of HCV. Among the 129 patients, 61 (47%) had antibody to C100-3, 76 (59%) had antibody to C33c and 74 (57%) had antibody to C22. Seventy-nine (61%) were reactive with at least one and 76 (59%) were reactive with at least two HCV peptides (this is the criterion used for hepatitis C virus antibody reactivity). A proportion of patients with chronic hepatitis and cirrhosis (55 of 91; 60%) similar to that of patients without cirrhosis (21 of 38; 55%) had hepatitis C virus antibody. No significant clinical, serum biochemical or histological differences were noted between the group of patients with hepatitis C virus antibody and those without this antibody reactivity. Thus more than half the patients with cryptogenic chronic liver disease had hepatitis C virus antibody, suggesting that chronic HCV infection plays a major role in the origin of cryptogenic chronic hepatitis and cirrhosis.     

Prevalence of antibodies to hepatitis C virus among Omani patients with renal disease

Summary The prevalence of hepatitis C virus (HCV) infection in Omani patients with renal disease was determined using a second-generation enzyme immunoassay which detects antibodies to three HCV antigens. Based on the results of this assay, 27 of 102 (26.5%) sera from patients on haemodialysis, 11 of 82 (13.4%) sera from kidney transplant patients, and 1 of 103 (1%) sera from non-dialysed, non-transplanted patients with various renal diseases had antibodies to HCV. Among healthy subjects, none of 134 medical students and 5 of 564 (0.9%) blood donors were anti-HCV positive. Thus, the prevalence of HCV infection in dialysis and renal transplant patients was significantly higher than that found in patients with renal disease who had been neither dialysed nor transplanted (p<0.05). In the latter group of patients, the frequency of anti-HCV was low, and comparable to that of healthy Omani subjects.

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Hepatitis C Virus-Antikörperprävalenz bei Nierenkranken aus dem Sultanat Oman

Zusammenfassung Die Prävalenz der Hepatitis C Virus- Infektion bei Nierenkranken aus Oman wurde durch Antikörperbestimmung gegen drei HCV-Antigene mit einem Enzymimmunassay der zweiten Generation ermittelt. Antikörper gegen HCV wurden bei 27 von 102 (26,5%) Hämodialysepatienten, 11 von 82 (13,4%) Nierentransplantatempfängern und 1 von 103 (1%) weder dialysepflichtigen noch transplantierten Patienten mit anderen Nierenerkrankungen im Serum nachgewiesen. In der Gruppe gesunder Kontrollen waren alle 134 Medizinstudenten negativ und 5 von 564 (0.9%) Blutspendern anti-HCV-positiv. Die Prävalenz der HCV-Infektion war folglich bei Dialysepatienten und Nierentransplantatempfängern signifikant höher als bei Nierenkranken ohne Dialyse und Transplantation (p<0,05). In der letztgenannten Gruppe war die anti-HCV-Prävalenz ebenso niedrig wie bei gesunden Kontrollpersonen aus dem Sultanat Oman.

     

Risk of hepatitis C virus infection among household contacts of Saudi patients with chronic liver disease

SUMMARY. To evaluate the intrafamilial transmission of heptitis C virus and related risk factors among the Saudi population, two groups were investigated: 120 index patients with chronic liver disease and their 127 family contacts, and 220 blood donors who were anti-HCV-positive but with no chronic liver disease and their 91 family contacts. After a questionnaire on the risk factors for parenteral exposure, blood samples were obtained and tested for liver biochemistry and antibody to HCV (anti-HCV) by a third-generation enzyme immunoassay (UBI HCV HA4.0). Only two spouses of 20 index patients were anti-HCV-positive while the remaining 125 family contacts were anti-HCV-negative. None of the 91 family contacts of the 20 anti-HCV-positive blood donors was anti-HCV-positive. The two spouses were wives of index patients but had a history of blood transfusion on at least two different occasions. Our results clearly indicate the intrafamilial transmission of HCV is not the route of transmission of HCV among Saudis and our results argue against sexual transmission of hepatitis C virus despite a relatively long duration of marriage.     

Prevalence of hepatitis C virus antibodies in chronic liver disease and hepatocellular carcinoma patients in India

The prevalence of antibodies to hepatitis C virus (HCV) was investigated in 129 patients with chronic liver disease (85 with chronic active hepatitis and 44 with cirrhosis) and 53 patients with hepatocellular carcinoma. The commercially available second generation anti-HCV enzyme immunoassay kit was used. Antibodies to hepatitis C virus were detected in 16.2% of the patients with chronic liver disease and in 15.1% with hepatocellular carcinoma. Of the HCV positive patients in all groups 51.7% were positive for hepatitis B virus (HBV) markers indicating present or past infection. Prevalence of HBV markers in all the three groups (CAH, cirrhosis and HCC) was higher as compared with anti-HCV prevalence. These results suggest that HCV infection may not be a major cause of chronic liver disease and hepatocellular carcinoma in India and indicate the presence of other aetiological agents.     

慢性肝病患者HCV与HBV重叠感染与预后

目的探讨ＨＣＶ与ＨＢＶ重叠感染对慢性肝病过程、预后及对乙型肝炎病毒复制的影响。方法应用第二代抗＿ＨＣＶＥＬＩＳＡ及ＲＴ＿ＰＣＲ法测定１８７例ＨＢｓＡｇ阳性慢性肝病患者抗＿ＨＣＶ及ＨＣＶ＿ＲＮＡ，并对ＨＣＶ与ＨＢＶ重叠感染者的肝损害，ＨＣＶ，ＨＢＶ间的相互作用及预后进行分析。结果抗＿ＨＣＶ，ＨＣＶ＿ＲＮＡ的阳性率在慢性肝炎（轻度）１３．３％，慢性肝炎（中～重度）１６．１％，肝硬变２２．７％，慢性重型肝炎６３．６％，肝细胞癌１３．３％。平均阳性率１８．２％，慢性重型肝炎抗＿ＨＣＶ，ＨＣＶ＿ＲＮＡ的检出率最高，明显高于肝脏损害的其他肝病（Ｐ＜０．０５），近半数以上ＨＣＶ慢性感染已与ＨＢＶ重叠感染。结论ＨＣＶ与ＨＢＶ重叠感染的慢性肝病患者预后较差。但并未发现ＨＣＶ对ＨＢＶ复制具有阻遏作用。     

Seroprevalence of hepatitis C virus nucleocapsid antibodies in patients with cryptogenic chronic liver disease.

The serological responses to two different hepatitis C virus antigens were studied by enzyme-linked immunosorbent assay in a variety of chronic liver diseases and in healthy blood donors. The study population comprised 97 cases of cryptogenic chronic liver disease (40% with a history suggestive of parenterally transmitted non-A, non-B hepatitis and 60% without such a history), 87 cases of other well-characterized chronic liver diseases and 96 voluntary blood donors. The commercially available C100-3 assay and a new assay utilizing a 22 kD recombinant protein (c22) from the nucleocapsid region of the virus were used for antibody detection. Overall in the non-A, non-B hepatitis group, 77% were positive for anti-c22, 55% were positive for anti-C100-3 and 24% were negative by both tests. In the parenterally transmitted chronic liver disease group, 82% were positive for anti-C100-3 and 90% were positive for anti-c22 (not significant). In the cryptogenic chronic liver disease cases 36% were positive for anti-C100-3 and 67% were positive for anti-c22 (p less than 0.001). Only in one case (a patient with hepatitis B virus infection) was anti-C100-3 detected without concomitant anti-c22. None of the voluntary blood donors had detectable hepatitis C virus antibodies. The new enzyme-linked immunosorbent assay test for anti-c22 would appear to be a more sensitive indicator of chronic hepatitis C virus infection than the existing commercial test, suggesting a useful diagnostic role in both cases of cryptogenic chronic non-A, non-B hepatitis liver disease and for the screening of blood products for prevention of hepatitis after transfusion.     

Detection of hepatitis C virus antibody in patients with autoimmune hepatitis and other chronic liver diseases.

To clarify the relationship between autoimmune hepatitis (AIH) and the hepatitis C virus (HCV), we investigated the prevalence of antibodies to HCV (anti-HCV) by an enzyme-linked immunosorbent assay in patients with AIH, primary biliary cirrhosis (PBC), rheumatoid arthritis and multiple myeloma. The antibody was detected in 9 out of 18 patients with AIH (50%), in 3 out of 23 with PBC (23%), in 2 out of 10 with rheumatoid arthritis (20%), and in 5 out of 9 with multiple myeloma (56%). However, the optical density values in these patients were lower than those observed in non-A, non-B hepatitis (NANBH). Anti-HCV became negative immediately after the initiation of glucocorticoid therapy in all four antibody-positive AIH patients tested. The extracted immunoglobulin G fraction from sera of 5 anti-HCV negative AIH patients became positive for the antibody. This phenomenon was not observed in 5 normal volunteer sera. The 9 family members of three anti-HCV positive AIH patients showed no anti-HCV positivity. These results suggest that autoantibodies in AIH patients may cross-react with the HCV-related antigen. Direct association of the HCV influencing the development of AIH is unlikely. Therefore, care should be taken in the evaluation of anti-HCV positivity in patients with autoimmune diseases and multiple myeloma.     

Detection of hepatitis C virus antibodies with new recombinant antigens: assessment in chronic liver diseases.

A new serological assay to detect antibodies against hepatitis C, based on a recombinant protein (BHC10) which incorporates structural and non-structural viral antigens, was tested in 67 healthy subjects and 409 patients with various forms of liver disease. Results were compared with the current assay based on the recombinant non-structural viral antigen c100 and with the recently introduced second-generation assay, Ortho2. None of the healthy subjects was positive by any of the assays. In patients with chronic non-A, non-B hepatitis the prevalence of anti-BHC10 was 96.8%, higher than anti-c100 (83.3%, p less than 0.001) and similar to Ortho2 (94.3%). False-positive results were less frequently found when BHC10 was used. These findings show that assays incorporating structural and non-structural antigens provide higher sensitivity to detect hepatitis C virus infection and they define an almost exclusive role of hepatitis C virus in the genesis of chronic non-A, non-B hepatitis.     

慢性丙型肝炎患者心血管疾病研究进展

丙型肝炎病毒（HCV）具有嗜肝性和泛嗜性,除造成肝脏损伤外,也表现出大量的肝外表现。近年来研究表明,慢性丙型肝炎患者心血管疾病发生率较高。HCV感染可造成动脉粥样硬化、心肌病、心肌炎、肺动脉高压等,成为心血管疾病的危险因素。     

替比夫定联合胸腺肽α-1治疗慢性乙型肝炎患者80例疗效分析

目的 观察替比夫定联合胸腺肽α-1治疗慢性乙型肝炎患者的早期疗效。方法 将80例慢性乙型肝炎患者随机分为替比夫定联合胸腺肽α-1治疗组40例和拉米夫定联合胸腺肽α-1治疗组40例。采用ELISA法检测血清HBV标志物,采用荧光定量PCR法检测血清HBV DNA。观察两组治疗12 w的疗效。结果 在治疗8 w末,替比夫定治疗患者血清HBV DNA阴转率和HBeAg阴转率分别为32.5%和20.0%,与拉米夫定治疗患者比,无显著性相差（分别为17.5%和5.0%,P>0.05）,在治疗12 w末,替比夫定治疗患者血清HBV DNA阴转率显著高于拉米夫定治疗患者（95.0%对62.5%,P<0.05）;在治疗12 w末,替比夫定治疗患者完全应答、部分应答和无应答率分别为57.5%、40.0%和2.5%,而拉米夫定治疗患者则分别为37.5%、 45.0%和17.5%,其中完全应答率显著高于拉米夫定组（P<0.05）。结论 替比夫定联合胸腺肽α-1治疗慢性乙型肝炎患者早期疗效更优。     

Prevalence of antibodies to hepatitis C virus in HBsAg negative hemodialysis patients.

The prevalence of hepatitis C virus (HCV) infection was estimated in a 14-month study using anti-C100-3 antibody assay in 31 HBsAg negative patients on maintenance hemodialysis (MHD) for > or = 3 months. One and three patients respectively had ALT elevation and anti-HCV positivity at entry. During MHD (mean period of follow up 9.9 mo), 11 (35.5%) patients had, on fortnightly estimation, ALT elevation which lasted for < or = 6 months in seven patients and for > 6 months in four. Fourteen (45.2%) patients had anti-HCV (including the three positive at entry). There was no significant difference in frequency of anti-HCV positivity in patients with normal and elevated ALT (57.1% and 42.9% respectively). The number of blood transfusions and duration of MHD were similar in anti-HCV positive and anti-HCV negative patients. We conclude that our MHD patients have a high frequency of hepatitis and anti-HCV positivity, and these may not be related to blood transfusions.     

Prevalence of and changes in hepatitis C virus antibodies in 64 patients with liver transplant

The aim of this retrospective study was to assess the prevalence of hepatitis C virus antibodies and their follow-up in a series of 64 orthotopic liver transplantation patients. Indications for transplantation were cirrhosis in 28 cases, primary biliary cirrhosis in 6 cases, liver cancer in 11 cases, fulminant hepatitis in 2 cases, and alveolar echinococcosis in 17 cases. The prevalence of serum antibodies to hepatitis C virus was assessed by an ELISA test (Ortho-Diagnostic-Systems). Sera were tested before liver transplantation and every two months after. Twenty-nine patients seronegative before transplantation remained negative. Four patients seropositive before liver transplantation remained seropositive. Twenty-eight patients seropositive before transplantation, became seronegative after, and 3 patients seronegative before transplantation became seropositive after. The prevalence of seroconversion was 9.3 percent. The prevalence of seropositive patients after transplantation was 11 percent. The high number of seropositive patients before transplantation (50 percent) could be explained by false positive results. Seropositivity before transplantation appeared to be related to hypergammaglobulinemia (p less than 0.001). This hypothesis was confirmed a posteriori by a concomitant disappearance of both seropositivity and hypergammaglobulinemia after transplantation in 62 percent of patients.     

Prevalence of antibody to hepatitis C virus among Saudi Arabian children: a community-based study.

In a population-based survey, 39 (0.90%) of 4,496 Saudi Arabian children (ages 1 to 10) were positive for antibody to hepatitis C virus. No significant difference was seen between the prevalence rate in males (0.9%) and females (0.8%) or between urban (0.7%) and rural dwellers (1.0%). A significant variation of rates (0% to 5.7%) was seen from one region to another. The Gizan population, noted for hyperendemic hepatitis B virus infection, had the highest prevalence of antibody to hepatitis C virus despite its cultural and socioeconomic similarities to other regions. In some regions of Saudi Arabia the prevalence of antibody to hepatitis C virus among children was 0% despite endemic rates for both hepatitis B virus and hepatitis A virus infections. An inverse relationship between age and antibody to hepatitis C virus positivity was noted, suggesting an early acquisition of infection in the population studied. Although the overall prevalence of antibody to hepatitis C virus in Saudi children appears low, endemic foci exist where transmission of infection appears to occur early in childhood. The significance of this characteristic for the incidence of chronic sequelae of hepatitis C virus infection needs further evaluation.     

Detection of hepatitis C virus antibodies and hepatitis C virus RNA in patients with alcoholic liver disease.

The relationship between alcoholic liver disease and hepatitis C virus was studied in 80 patients by searching for hepatitis C virus RNA with the polymerase chain reaction and by measuring hepatitis C virus antibodies. By C-100 enzyme-linked immunosorbent assay, hepatitis C virus antibodies were found in 2 of 10 patients with fibrosteatosis, 8 of 20 patients with alcoholic hepatitis, 14 of 19 patients with chronic hepatitis and 19 of 31 patients with cirrhosis. Percentages of patients with antibodies found by C-100 radioimmunoassay and by enzyme-linked immunosorbent assay based on sequence peptide 42 were lower; of the 16 patients with a low titer by C-100 enzyme-linked immunosorbent assay, 10 were negative by radioimmunoassay and 6 were negative by sequence peptide 42. By a second-generation recombinant immunoblot assay, hepatitis C virus antibodies were found in 1 of 10 patients with fibrosteatosis, 2 of 20 patients with alcoholic hepatitis, 15 of 19 patients with chronic hepatitis and 18 of 31 patients with cirrhosis. Hepatitis C virus RNA was found in 1 of 10 patients with fibrosteatosis, 3 of 20 patients with alcoholic hepatitis, 13 of 19 patients with chronic hepatitis and 20 of 31 patients with cirrhosis. Of the 37 patients with hepatitis C virus RNA, 31 had antibodies by C-100 enzyme-linked immunosorbent assay (25 patients at a high titer [cut-off index greater than 6]), and 31 had antibodies by second-generation recombinant immunoblot assay. Patients with cirrhosis and hepatitis C virus RNA had higher ALT activity than such patients without hepatitis C virus RNA (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)     

Detection of hepatitis C virus antibody in patients with autoimmune hepatitis and other chronic liver diseases

To clarify the relationship between autoimmune hepatitis (AIH) and the hepatitis C virus (HCV), we investigated the prevalence of antibodies to HCV (anti-HCV) by an enzyme-linked immunosorbent assay in patients with AIH, primary biliary cirrhosis (PBC), rheumatoid arthritis and multiple myeloma. The antibody was detected in 9 out of 18 patients with AIH (50%), in 3 out of 23 with PBC (23%), in 2 out of 10 with rheumatoid arthritis (20% ), and in 5 out of 9 with multiple myeloma (56% ). However, the optical density values in these patients were lower than those observed in non-A, non-B hepatitis (NANBH). Anti-HCV became negative immediately after the initiation of glucocorticoid therapy in all four antibodypositive AIH patients tested. The extracted immunoglobulin G fraction from sera of 5 anti-HCV negative AIH patients became positive for the antibody. This phenomenon was not observed in 5 normal volunteer sera. The 9 family members of three anti-HCV positive AIH patients showed no anti-HCV positivity. These results suggest that autoantibodies in AIH patients may cross-react with the HCV -related antigen. Direct association of the HCV influencing the development of AIH is unlikely. Therefore, care should be taken in the evaluation of anti-HCV positivity in patients with autoimmune diseases and multiple myeloma. This study was supported by the Ministry of Health, Science and Welfare of Japan.     

Prevalence of hepatitis C virus antibodies among blood donors in north-eastern Poland.

In many countries, screening blood donors for viral markers is an important source of information about epidemiology of HCV infection. The aim of this study was to determine seroprevalence of HCV infection among blood donors in north-eastern Poland and to compare it with prevalence of markers of other infections. We retrospectively analysed the results of tests for anti-HCV, HBsAg and anti-HIV of all blood donations performed in years 1998-2003. For HCV infection, full data (including all results of confirmatory tests) were available only for years 1998-2000. Overall prevalence of anti-HCV among all donors in years 1998-2000 was 0.5%. There was no significant difference in anti-HCV positivity rate of male and female donors. Majority of HCV infections occurred among first time donors (152/202; 75% of all HCV-positive results). The prevalence of anti-HCV among first time donors averaged 0.6% and remained at similar level as HBsAg (0.7%). The number of anti-HIV positives among first time donors remained low (mean prevalence 0.01%). We conclude that prevalence of anti-HCV among blood donors in podlaskie woiewodship is similar to prevalence in Poland but higher than reported for Western European countries and USA.