86 results on '"Susanne Polywka"'
Search Results
2. Clinical features of hepatitis E infections in patients with hematologic disorders
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Susanne Ghandili, Cecilia Lindhauer, Sven Pischke, Julian Schulze zur Wiesch, Philipp H. von Kroge, Susanne Polywka, Carsten Bokemeyer, Walter Fiedler, Nicolaus Kröger, Francis Ayuk, Raissa Adjallé, and Franziska Modemann
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Hepatitis E virus is increasingly being reported to cause chronic infection in immunocompromised patients. However, less is known about patients with an underlying hematologic disease. In particular, the impact of hepatitis E infection on oncological therapy has been poorly described. In this retrospective single-center study, we analyzed 35 hematologic patients with hepatitis E, including 20 patients under active oncological treatment and 15 patients who were in the posttreatment follow-up or under active surveillance. The primary aim was to describe the clinical courses with particular focus on any hepatitis E-related therapy modifications of cancer-directed therapy. In the majority (60%) of patients who were under active oncological treatment, hepatitis E-related therapy modifications were made, and 25% of deaths were due to progression of the hematologic disease. In patients receiving concomitant oncological treatment, no hepatitis Erelated deaths occurred. In contrast, two patients in the follow-up group died from hepatitis E-associated acute-onchronic liver failure. Chronic hepatitis E was observed in 34% of all cases and 43% received ribavirin therapy; of those, 27% achieved a sustained virological response. CD20-directed therapy was the only independent risk factor for developing chronic hepatitis E. We conclude that CD20-directed treatment at any time point is a risk factor for developing chronic hepatitis E. Nevertheless, since mortality from the progression of hematologic disease was higher than hepatitis E-related mortality, we suggest careful case-by-case decisions on modifications of cancer treatment. Patients in the posttreatment follow-up phase may also suffer from severe courses and hepatitis E chronicity occurs as frequently as in patients undergoing active therapy.
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- 2022
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3. High Clinical Manifestation Rate in an Imported Outbreak of Hepatitis E Genotype 1 Infection in a German Group of Travellers Returning from India
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Sven Pischke, Julian Schulze-zur-Wiesch, Marc Lütgehetmann, Benno Kreuels, Stefan Lueth, Petra Kapaun, Daniel Benten, Stefan Schmiedel, Martina Sterneck, Ansgar W. Lohse, and Susanne Polywka
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HEV ,Anti-HEV ,Serology ,Wantai-assay ,Mikrogen-assay ,Specialties of internal medicine ,RC581-951 - Abstract
Background: There are only few reports about travel-associated, imported tropical hepatitis E virus (HEV) genotype 1 infections within Western travellers. We describe the clinical course of a single outbreak of hepatitis E in a German travellers group returning from India and compare the results of two commercial HEV-seroassays. Material and Methods: After identifying hepatitis E in an index patient returning from a journey to India all 24 members of this journey were tested for anti-HEV-IgG and IgM using two commercial seroassays (Wantai and Mikrogen), for HEV-RNA by PCR and HEV-Ag by an antigen-assay (Wantai). Results: 5/24 (21%) individuals were viraemic with viral loads between 580-4,800,000 IU/mL. Bilirubin and ALT levels in these patients ranged from 1.3-14.9 mg/dL (mean 7.3 mg/dL, SD 5.6 mg/dL) and 151-4,820 U/L (mean 1,832U/L, SD 1842U/L), respectively and showed significant correlations with viral loads (r = 0.863, p < 0.001; r = 0.890, p < 0.001). No risk factor for food-borne HEV-transmission was identified. All viraemic patients (5/5) tested positive for anti-HEV-IgG and IgM in the Wantai-assay but only 4/5 in the Mikrogen-as-say. Wantai-HEV-antigen-assay was negative in all patients. Six months later all previously viraemic patients tested positive for anti-HEV-IgG and negative for IgM in both assays. However, two non-viremic individuals who initially tested Wantai-IgM-positive stayed positive indicating false positive results. Conclusions: Despite the exact number of exposed individuals could not be determined HEV genotype 1 infections have a high manifestation rate of more than 20%.The Wantai-antigen-test failed, the Wantai-IgM-rapid-test and the Mikrogen-IgM-recomblot showed a better performance but still they cannot replace real-time PCR for diagnosing ongoing HEV-infections.
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- 2017
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4. Lower Levels of Transaminases but Higher Levels of Serum Creatinine in Patients with Acute Hepatitis E in Comparison to Patients with Hepatitis A
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Thomas Theo Brehm, Omid Mazaheri, Thomas Horvatits, Marc Lütgehetmann, Julian Schulze zur Wiesch, Ansgar W. Lohse, Susanne Polywka, and Sven Pischke
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hepatitis E ,HEV ,extrahepatic manifestations ,renal impairment ,serum creatinine ,eGFR ,Medicine - Abstract
In patients with hepatitis E virus (HEV) infections, extrahepatic, particularly renal and hematological manifestations, are increasingly reported in the medical literature but have never been studied compared to a control cohort. We retrospectively analyzed medical records of consecutive patients that were diagnosed with acute hepatitis E (AHE) (n = 69) or acute hepatitis A (AHA) (n = 46) at the University Medical Center Hamburg Eppendorf from January 2009 to August 2019 for demographical, clinical, and laboratory information. Patients with AHE had significantly lower median levels of ALAT (798 U/L) and total bilirubin (1.8 mg/dL) compared to patients with AHA (2326 U/L; p < 0.001 and 5.2 mg/dL; p < 0.001), suggesting a generally less severe hepatitis. In contrast, patients with AHE had significantly higher median serum creatinine levels (0.9 mg/dL vs. 0.8 mg/dL; p = 0.002) and lower median estimated glomerular filtration rate (eGFR) (91 mL/min/1.73 m2 vs. 109 mL/min/1.73 m2; p < 0.001) than patients with AHA. Leucocyte, neutrophil and lymphocyte count, hemoglobin, platelets, red cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR), and RDW to lymphocyte ratio (RLR) did not differ between patients with AHE and those with AHA. Our observations indicate that renal but not hematological interference presents an underrecognized extrahepatic feature of AHE, while inflammation of the liver seems to be more severe in AHA.
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- 2021
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5. Significance of Anti-Nuclear Antibodies and Cryoglobulins in Patients with Acute and Chronic HEV Infection
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Thomas Horvatits, Julian Schulze zur Wiesch, Susanne Polywka, Gustav Buescher, Marc Lütgehetmann, Elaine Hussey, Karoline Horvatits, Sven Peine, Friedrich Haag, Marylyn M. Addo, Ansgar W. Lohse, Christina Weiler-Normann, and Sven Pischke
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hepatitis E ,HEV ,autoimmune response ,antibodies ,cryoglobulins ,Medicine - Abstract
Background: Hepatitis E virus (HEV) has been associated with immunological phenomena. Their clinical significance, however, still needs to be clarified, that is, whether cryoglobulins or autoantibodies impact overt disease in HEV-infected individuals. To better understand, we analyzed these different immune phenomena in three cohorts, each representing different types of HEV infection. Methods: The cohorts included: (i) immunocompetent patients with acute hepatitis E, (ii) immunosuppressed patients with chronic hepatitis E, and (iii) individuals with asymptomatic HEV infection. Together, they consisted of 57 individuals and were studied retrospectively for the presence of anti-nuclear antibodies (ANAs), cryoglobulins, and serum total IgG. They were then compared with a control cohort of 17 untreated patients with chronic hepatitis B virus (HBV) infection or hepatitis C virus (HCV) infection. Results: Thirteen (23%) were immunocompetent patients with acute hepatitis E (median alanine aminotransferase (ALT) = 872 U/L), 15 (26%) were immunosuppressed patients with chronic hepatitis E (median ALT = 137 U/L), and 29 (51%) were blood donors with asymptomatic HEV infection (median ALT = 35 U/L). Overall, 24% tested positive for elevated ANA titers of >1:160, and 11% presented with a specific ANA pattern. ANA detection was not associated with the type of HEV infection, IgG levels, sex, or age. All individuals tested negative for anti-mitochondrial antibodies, anti-neutrophil cytoplasmic antibodies, liver-kidney microsomal antibodies, anti-myeloperoxidase-, and anti-proteinase-3 antibodies. Five patients (9%) tested positive for cryoglobulins. Notably, cryoglobulinemia was present in overt hepatitis E (Groups (i) and (ii); one acute and four chronic HEV infections), but was not present in any of the asymptomatic blood donors (p = 0.02). The frequency of cryoglobulins and elevated ANAs did not differ significantly between HEV and HBV/HCV patients. Conclusion: In line with findings on HBV and HCV infections, we frequently observed detection of ANAs (24%) and cryoglobulins (9%) in association with HEV infections. The presence of cryoglobulins was limited to patients with overt hepatitis E. We add to the findings on the immune phenomena of hepatitis E.
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- 2020
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6. Hepatitis delta virus propagation enabled by hepatitis C virus—Scientifically intriguing, but is it relevant to clinical practice?
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Marc Lütgehetmann, Susanne Polywka, Lisa Sophie Pflüger, and Julian Schulze zur Wiesch
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Hepatitis B virus ,HBsAg ,viruses ,Hepatitis C virus ,Hepacivirus ,Dengue virus ,medicine.disease_cause ,Virus ,Serology ,03 medical and health sciences ,0302 clinical medicine ,Virology ,medicine ,Humans ,030212 general & internal medicine ,Seroconversion ,Hepatitis B Surface Antigens ,Hepatology ,business.industry ,virus diseases ,biochemical phenomena, metabolism, and nutrition ,Hepatitis B ,medicine.disease ,Hepatitis C ,digestive system diseases ,Infectious Diseases ,030211 gastroenterology & hepatology ,Hepatitis Delta Virus ,Viral hepatitis ,business - Abstract
In vitro cell culture experiments and animal models have demonstrated that hepatitis delta virus (HDV) can theoretically propagate being enveloped by human pathogenic viruses other than hepatitis B virus (HBV), namely hepatitis C virus (HCV) and dengue virus. However, the clinical relevance of these findings and whether HDV replication occurs in real-world hepatitis B surface antigen (HBsAg)-negative HCV patient cohorts remain unknown. To this aim, we analysed 323 HCV-RNA-positive and HBsAg-negative sera for the presence of HDV-RNA and anti-HDV antibodies (anti-HDV). All 323 (100%) samples were negative for HDV-RNA. Interestingly, 8/316 samples tested positive for anti-HDV. The HBV serology of these eight patients showed a positive result for HBV core antibodies (anti-HBc) indicating a seroconversion of an acute HBV infection in the past. None of the anti-HBc-negative patients were positive for anti-HDV. Our results indicate a distinctly low probability of replicative HDV infection in HCV mono-infected patients in Germany. Current German clinical guidelines rightly recommend performing HDV screening only in HBsAg-positive patients. However, larger studies on this subject should be performed in regions that are endemic for chronic HBV/HDV as well as HCV infections.
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- 2020
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7. Relevance of HEV detection in ejaculate of chronically infected patients
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Mathias Schemmerer, Marc Luetgehetmann, Hans Bock, Jörn Schattenberg, Samuel Huber, Susanne Polywka, M Mader, Ansgar Lohse, Daniel Todt, Eike Steinmann, Jürgen Wenzel, Thomas Horvatits, and Sven Pischke
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Hepatology - Published
- 2022
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8. Course of HEV viremia and anti-HEV IgM/IgG response in asymptomatic blood donors
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D. Westhölter, Susanne Polywka, Ansgar W. Lohse, Sven Peine, Christian Kraef, Marc Lütgehetmann, Thomas Horvatits, Christian Schlein, Ulrike W. Denzer, Jens Hiller, and Sven Pischke
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Adult ,Male ,0301 basic medicine ,Adolescent ,Genotype ,viruses ,Medizin ,Blood Donors ,Viremia ,Antibodies, Viral ,medicine.disease_cause ,Polymerase Chain Reaction ,Asymptomatic ,Epitope ,Serology ,Cohort Studies ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Immune system ,Hepatitis E virus ,Virology ,medicine ,Humans ,030212 general & internal medicine ,Asymptomatic Infections ,Aged ,Subclinical infection ,business.industry ,virus diseases ,Middle Aged ,Hepatitis E ,medicine.disease ,digestive system diseases ,030104 developmental biology ,Infectious Diseases ,Immunoglobulin M ,Immunoglobulin G ,Immunology ,RNA, Viral ,Female ,medicine.symptom ,business - Abstract
Background Globally, an estimated 20 million Hepatitis E infections occur every year. The course of viremia and antibody response has been investigated in patients with symptomatic hepatitis E. However, the majority of HEV infections in industrialized countries take a subclinical course. Objectives To investigate the course of HEV viremia and epitope specific anti-HEV IgM/IgG response in asymptomatic blood donors in order to understand the immune response and viral clearance in asymptomatic blood donors with HEV infections. Methods In this study 27 HEV viremic donors were identified by HEV-PCR during routine screening of blood donors and the course of anti-HEV IgM/IgG and HEV-RNA was retrospectively studied using RT-PCR and a commercial immunoblot (Mikrogen®) allowing classification of the antibody response according to HEV epitopes. Results At time of donation, serological testing failed to identify viremic donors as 70.4% had no detectable antibody response. Anti-HEV IgM could be detected in 22.2% of viremic donors while anti-HEV IgG could be found in 7.4%. At least three donors experienced prolonged viremia beyond 100 days. Spontaneous HEV-RNA clearance within a median time span of 57 days was observed in all 27 donors. In all donors anti-HEV IgG specific for the immunogenic viral epitope O2C could be detected in close temporal association with viral clearance. Conclusion Serological testing is inappropriate for identifying HEV-viremic blood donors. Acute HEV infection in asymptomatic blood donors can persist for more than 100 days. HEV-RNA clearance coincided with the appearance of anti-HEV IgM/IgG confirming the importance of a B-cell mediated response in clearing acute infections. Anti-HEV IgM and IgG specific for the epitope O2C are associated with the clearance of HEV-viremia.
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- 2018
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9. Blood-borne HEV transmission: A one year experience with routine HEV screening at a tertiary center
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Ansgar W. Lohse, Marc Lütgehetmann, Sven Pischke, Jens Hiller, Ulrike W. Denzer, D. Westhölter, Susanne Polywka, and Sven Peine
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Transmission (mechanics) ,business.industry ,law ,Gastroenterology ,Medicine ,Center (algebra and category theory) ,Medical emergency ,business ,medicine.disease ,law.invention - Published
- 2018
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10. Transfusion-transmitted hepatitis E virus infections: a risk for immunosuppressed patients
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Johannes Hartl, Sven Pischke, Marc Lütgehetmann, Susanne Polywka, D. Westhölter, M Rybszynski, Ansgar W. Lohse, Jens Hiller, Francis Ayuk, Sven Peine, and Ulrike W. Denzer
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Hepatitis E virus ,business.industry ,Gastroenterology ,Medicine ,business ,medicine.disease_cause ,Virology - Published
- 2018
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11. Development of autoantibodies against 'rings and rods'-associated IMPDH2 in chronic hepatitis C genotype 1 infection during protease inhibitor based triple therapy in a 'real life' cohort
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Inga M Dettmann, Swantje Mindorf, Lars Komorowski, Susanne Polywka, Malte H. Wehmeyer, Winfried Stöcker, Stefan Lüth, Werner Dammermann, and J Schulze zur Wiesch
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Chronic hepatitis ,business.industry ,Immunology ,Cohort ,Genotype ,Gastroenterology ,Autoantibody ,Medicine ,Protease inhibitor (pharmacology) ,business - Published
- 2016
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12. Efficacy and safety of sofosbuvir/ledipasvir for the treatment of patients with hepatitis C virus re-infection after liver transplantation
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Michael P. Manns, H Mix, R. Costa, Martina Sterneck, H. Wedemeyer, V M Proske, Sandra Ciesek, Bjoern Nashan, Juergen Klempnauer, Ansgar W. Lohse, Benjamin Otto, M. Lüthgehetmann, T. von Hahn, Sven Pischke, and Susanne Polywka
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Male ,Ledipasvir ,medicine.medical_specialty ,Genotype ,Sofosbuvir ,Hepatitis C virus ,medicine.medical_treatment ,Hepacivirus ,Liver transplantation ,medicine.disease_cause ,Antiviral Agents ,Gastroenterology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,Ribavirin ,medicine ,Humans ,Aspartate Aminotransferases ,030212 general & internal medicine ,Aged ,Retrospective Studies ,Fluorenes ,Transplantation ,medicine.diagnostic_test ,business.industry ,Alanine Transaminase ,Hepatitis C ,Middle Aged ,medicine.disease ,Liver Transplantation ,Surgery ,Europe ,Regimen ,Treatment Outcome ,Infectious Diseases ,chemistry ,Benzimidazoles ,Female ,030211 gastroenterology & hepatology ,Liver function tests ,business ,medicine.drug - Abstract
Background Hepatitis C virus (HCV) infection is associated with a particularly poor outcome after liver transplantation. In December 2014, sofosbuvir/ledipasvir (SOF/LDV) fixed-dose combination (FDC) was approved for HCV genotype 1 and 4 in Europe. In orthotopic liver transplantation (OLT) recipients, the interferon-free treatment of HCV re-infection with novel direct-acting antivirals has been demonstrated to be safe and effective in clinical trials, but real-world data are missing. The aim of this study was to investigate the safety and efficacy of SOF/LDV FDC in OLT recipients in the real-life setting. Methods All consecutive OLT patients started on SOF/LDV FDC for 12 or 24 weeks at the University Medical Center Hamburg-Eppendorf and Medical School Hannover between October 2014 and August 2015 were retrospectively analyzed (n = 30). The primary efficacy endpoint was sustained virological response (SVR), i.e., absence of viremia 12 weeks after end of treatment (SVR 12). Liver function tests, creatinine, blood count, and HCV RNA (by polymerase chain reaction assay) were determined at each visit. Results SVR was achieved in 29/30 patients (96.67%) treated with SOF/LDV ± ribavirin (RBV) for 12 (n = 4) or 24 weeks (n = 25). Twenty-five patients (86.2%) received RBV. However, in 15 of the 25 patients, RBV administration had to be discontinued because of severe anemia (57.7%). One RBV-treated patient died of a myocardial infarction during antiviral therapy; this event was most likely not directly related to SOF/LDV. Aside from RBV-associated anemia, no severe side effects of the antiviral regimen were observed. Conclusion Antiviral treatment with SOF/LDV is highly effective, safe, and well tolerated in OLT recipients. The addition of RBV often results in severe anemia, requiring dose reduction or discontinuation.
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- 2016
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13. Human liver chimeric mice as a new model of chronic hepatitis E virus infection and preclinical drug evaluation
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Sofia Gass, Marc Lütgehetmann, Gianna Rapp, Eva Herker, Susanne Polywka, Anja Schöbel, Lena Allweiss, Maura Dandri, Tassilo Volz, Katja Giersch, Sven Pischke, Anne Groth, Ansgar W. Lohse, and J Kah
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0301 basic medicine ,viruses ,Drug Evaluation, Preclinical ,Viremia ,Mice, SCID ,Biology ,Real-Time Polymerase Chain Reaction ,Virus Replication ,medicine.disease_cause ,Antiviral Agents ,Virus ,Serology ,Mice ,03 medical and health sciences ,chemistry.chemical_compound ,Hepatitis E virus ,medicine ,Animals ,Humans ,In Situ Hybridization ,Hepatology ,Ribavirin ,virus diseases ,Hepatitis E ,medicine.disease ,Virology ,digestive system diseases ,Disease Models, Animal ,Chronic infection ,030104 developmental biology ,Liver ,Viral replication ,chemistry ,Immunology ,RNA, Viral - Abstract
Background & Aims Hepatitis E virus (HEV) is a major cause of acute hepatitis as well as chronic infection in immunocompromised individuals; however, in vivo infection models are limited. The aim of this study was to establish a small animal model to improve our understanding of HEV replication mechanisms and permit the development of effective therapeutics. Methods UPA/SCID/beige mice repopulated with primary human hepatocytes were used for infection experiments with HEV genotype (GT) 1 and 3. Virological parameters were determined at the serological and intrahepatic level by real time PCR, immunohistochemistry and RNA in situ hybridization. Results Establishment of HEV infection was achieved after intravenous injection of stool-derived virions and following co-housing with HEV-infected animals but not via inoculation of serum-derived HEV. GT 1 infection resulted in a rapid rise of viremia and high stable titres in serum, liver, bile and faeces of infected mice for more than 25weeks. In contrast, viremia in GT 3 infected mice developed more slowly and displayed lower titres in all analysed tissues as compared to GT 1. HEV-infected human hepatocytes could be visualized using HEV ORF2 and ORF3 specific antibodies and HEV RNA in situ hybridization probes. Finally, six-week administration of ribavirin led to a strong reduction of viral replication in the serum and liver of GT 1 infected mice. Conclusion We established an efficient model of HEV infection to test the efficacy of antiviral agents and to exploit mechanisms of HEV replication and interaction with human hepatocytes in vivo.
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- 2016
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14. SAT-208-Zinc/Ribavirin: A possible treatment option in chronically HEV genotype 3 infected patients without SVR under ribavirin monotherapy
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Vincent Mallet, Thomas Horvatits, Susanne Polywka, Sven Pischke, Julian Schulze zur Wiesch, Michael P. Manns, Marc Lütgehetmann, Patrick Behrendt, Karoline Rutter, Nassim Kamar, Niels Schübel, Anne Marie Roque-Afonso, and Ansgar W. Lohse
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medicine.medical_specialty ,Hepatology ,business.industry ,Ribavirin ,chemistry.chemical_element ,Treatment options ,Zinc ,Gastroenterology ,chemistry.chemical_compound ,chemistry ,Internal medicine ,Genotype ,medicine ,business - Published
- 2019
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15. Course of hepatitis C virus (HCV) RNA and HCV core antigen testing are predictors for reaching sustained virologic response in liver transplant recipients undergoing sofosbuvir treatment in a real-life setting
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Ansgar W. Lohse, Sabine Jordan, Martina Sterneck, Bjoern Nashan, Sven Pischke, Susanne Polywka, Valesca Marie Proske, and M. Lang
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Adult ,Male ,medicine.medical_specialty ,Orthotopic liver transplantation ,Sofosbuvir ,Hepatitis C virus ,Hepacivirus ,Real life setting ,medicine.disease_cause ,Antiviral Agents ,Gastroenterology ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Ribavirin ,medicine ,Humans ,030212 general & internal medicine ,Aged ,Transplantation ,business.industry ,Viral Core Proteins ,virus diseases ,Orthotopic Liver Transplant ,Middle Aged ,Viral Load ,Hepatitis C ,Virology ,digestive system diseases ,Liver Transplantation ,Regimen ,Infectious Diseases ,Virologic response ,RNA, Viral ,Female ,030211 gastroenterology & hepatology ,Hcv core antigen ,business ,medicine.drug - Abstract
BACKGROUND Hepatitis C virus (HCV) infection is associated with reduced graft survival in orthotopic liver transplant recipients. Treatment with the new direct-acting antivirals (DAAs) is safe and efficient, but no reliable predictive factors for sustained virologic response (SVR) have been identified so far. The HCV core antigen assay (HCV-core-Ag) is a new, inexpensive, and efficient method to detect viral antigens, but the value of this technique to predict treatment response in orthotopic liver transplantation (OLT) patients is still unclear. METHODS All OLT patients who were treated with a sofosbuvir-based antiviral regimen at our center between March 2014 and August 2014 were included in the analysis (n = 20). HCV-core-Ag and HCV RNA (polymerase chain reaction [PCR]) were determined at each visit. Primary endpoints of this study were SVR at 4 or 12 weeks after end of treatment (SVR 4 and SVR 12). RESULTS HCV-core-Ag tested negative after a median of 2 weeks (range 1-16 weeks) while PCR tests became negative after a median of 4 weeks (range 2-12 weeks). Time until PCR negativity and until HCV-core-Ag negativity showed a good correlation (R = 0.711, P < 0.001, Fig. ). Seventeen of 20 patients (85%) achieved SVR 12. SVR 12 was associated with a short time interval between treatment start and HCV PCR negativity (P = 0.005) or HCV-core-Ag negativity (P = 0.003, Mann-Whitney test). No severe side effects were observed. CONCLUSIONS DAA treatment is safe and well tolerated in OLT. The time points of HCV-core-Ag loss and PCR negativity were predictors of SVR 12.
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- 2016
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16. Comparison of autochthonous and imported cases of hepatitis A or hepatitis E
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Marylyn M. Addo, Maura Dandri, Martina Sterneck, Johannes Hartl, M. Luethgehetmann, Werner Dammermann, Sven Pischke, Benno Kreuels, AW Lohse, and Susanne Polywka
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Bilirubin ,viruses ,medicine.disease_cause ,Sensitivity and Specificity ,Gastroenterology ,Diagnosis, Differential ,Young Adult ,chemistry.chemical_compound ,Hepatitis E virus ,Cholestasis ,Germany ,Internal medicine ,medicine ,Humans ,In patient ,Transaminases ,Aged ,Hepatitis ,business.industry ,Reproducibility of Results ,virus diseases ,Hepatitis A ,Emigration and Immigration ,Middle Aged ,Hepatitis B ,Hepatitis E ,medicine.disease ,digestive system diseases ,chemistry ,Immunology ,Female ,Bilirubin levels ,business ,Biomarkers - Abstract
Background: Hepatitis A and hepatitis E are not limited to tropical countries but are also present in industrialized countries. Both infections share similar clinical features. There is no comparative study evaluating the clinical parameters of autochthonous and imported hepatitis A virus and hepatitis E virus infections. Aims: The aim of this study was to determine differences between autochthonous and imported hepatitis A virus (HAV) and hepatitis E virus (HEV) infections. Methods: Medical charts of all patients at our center with acute HAV and HEV infections were analyzed retrospectively (n = 50, study period 01/2009 – 08/2013). Results: Peak bilirubin (median 8.6 vs. 4.4 mg/dL, p = 0.008) and ALT levels (median 2998 vs. 1666 IU/mL, p = 0.04) were higher in patients with hepatitis A compared to hepatitis E. In comparison to autochthones hepatitis E cases, patients with imported infections had significantly higher peak values for AST, ALT, bilirubin and INR (p = 0.009, p = 0.002, p = 0.04 and p = 0.049, respectively). In HAV infection, AST levels tended to be higher in imported infections (p = 0.08). Conclusions: (i) It is not possible to differentiate certainly between acute HAV and HEV infections by clinical or biochemical parameters, however, HAV infections might be associated with more cholestasis and higher ALT values. (ii) Imported HEV infections are associated with higher transaminases, INR and bilirubin levels compared to autochthonous cases and (iii) imported HAV infections tend to be associated with higher transaminases in comparison to autochthonous cases.
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- 2015
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17. Persisting hepatitis E virus infection leading to liver cirrhosis despite recovery of the immune system in an HIV-infected patient
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H. Herbst, M. Obermeier, Susanne Polywka, Sven Pischke, P. Ingiliz, and C. Mayr
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Liver Cirrhosis ,Male ,Cirrhosis ,viruses ,HIV Infections ,Inflammation ,Antiviral Agents ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Immune system ,Hiv infected ,Ribavirin ,Hepatitis E virus ,Humans ,Medicine ,In patient ,030212 general & internal medicine ,Immune status ,Hepatology ,business.industry ,Gastroenterology ,virus diseases ,Middle Aged ,medicine.disease ,digestive system diseases ,Hepatitis E ,chemistry ,DNA, Viral ,Immunology ,030211 gastroenterology & hepatology ,medicine.symptom ,business ,Hepatitis E virus infection - Abstract
Chronic hepatitis E has been described several times in strongly immunosuppressed HIV-patients. We describe the persistence of HEV-infection in an HIV-patient despite a restored immune response. This case demonstrates that HEV-infection can persist in formerly immunosuppressed individuals irrespective of the current immune status. Persisting HEV-infection can lead to chronic inflammation and liver cirrhosis. Physicians should be aware of the possibility of chronic hepatitis E even in patients that are not any longer immunocompromised. However, ribavirin is an efficient treatment option.
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- 2016
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18. SAT-215-Cryoglobulinemia in asymptomatic, symptomatic acute and chronical HEV infections
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Ansgar W. Lohse, Thomas Horvatits, Sven Pischke, Julian Schulze zur Wiesch, Rabea Lübke, Karoline Rutter, D. Westhölter, Marc Lütgehetmann, Susanne Polywka, and Peine Sven
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medicine.medical_specialty ,Hepatology ,business.industry ,Internal medicine ,medicine ,medicine.symptom ,medicine.disease ,business ,Cryoglobulinemia ,Asymptomatic ,Gastroenterology - Published
- 2019
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19. From IEDs to AIDS? Detection of HIV in human corpses by rapid screening tests after suspected intentional transmission in terrorist attacks
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Susanne Polywka, Hagen Frickmann, D Sturm, Ulrike Loderstaedt, R. M. Hagen, and B Wulff
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medicine.medical_specialty ,Human immunodeficiency virus (HIV) ,Poison control ,HIV Infections ,medicine.disease_cause ,Sensitivity and Specificity ,Suicide prevention ,Occupational safety and health ,Acquired immunodeficiency syndrome (AIDS) ,Cadaver ,medicine ,Humans ,Mass Screening ,Acquired Immunodeficiency Syndrome ,Transmission (medicine) ,business.industry ,virus diseases ,social sciences ,General Medicine ,medicine.disease ,Surgery ,Biological warfare ,Terrorism ,Medical emergency ,business - Abstract
Objectives We evaluated the feasibility of intentional transmission of HIV by means of suicide bombing and rape as a terrorist tactic in asymmetric conflicts by evaluating the recognised optimum conditions for biological warfare. We also estimated the suitability of a fourth-generation rapid test for HIV detection in the blood of dead terrorists killed in the completion of their mission. Methods The feasibility of deliberate transmission of HIV for terroristic ends was evaluated on the basis of published experience from passive biological warfare research. In addition, blood from four recently deceased HIV-positive patients and four HIV-negative control corpses, stored at 4°C in a mortuary, was analysed at 12, 24, 36 and 48 h postmortem by rapid serological testing. Results The feasibility of HIV infection for terroristic purposes was established. The fourth-generation HIV rapid test we evaluated identified all HIV-positive samples and was negative for all HIV-negative samples. Conclusions Rapid HIV testing from the remains of dead terrorists in the deployed military environment is possible. Samples should be acquired quickly, basic sample preparation is advisable and consequent decisions concerning postexposure prophylaxis should take into account the diagnostic gap in early infections.
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- 2013
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20. HEV-Übertragung durch Blutprodukte: ein Risiko für Immunsupprimierte
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AW Lohse, Marc Lütgehetmann, Francis Ayuk, Sven Pischke, M Rybczynski, Jens Hiller, and Susanne Polywka
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Gastroenterology - Published
- 2016
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21. Virus NAT for HIV, HBV, and HCV in Post-Mortal Blood Specimens over 48 h after Death of Infected Patients First Results
- Author
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Axel Pruss, Susanne Polywka, Carolin Edler, Birgit Wulff, Ann Sophie Schröder, Ulrich Kalus, Thomas Meyer, and Ina Wilkemeyer
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Pathology ,medicine.medical_specialty ,business.industry ,Virus safety ,Human immunodeficiency virus (HIV) ,Context (language use) ,Hematology ,medicine.disease_cause ,Virology ,Virus ,Original Article • Originalarbeit ,Tissue Donation ,Nat ,Immunology and Allergy ,Medicine ,business - Abstract
Objective According to EU regulations (EU directive 2006/17/EC), blood specimens for virologic testing in the context of post-mortal tissue donation must be taken not later than 24 h post mortem.
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- 2012
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22. 45. Jahreskongress der Deutschen Gesellschaft für Transfusionsmedizin und Immunhämatologie (DGTI)
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Jan Schroeter, Michael Schmidt, Frithjof Herrlinger, Birgit Wulff, Reinhold A. Schiller, Mark David Smith, Torsten Tonn, Ralf Knels, Knut Gubbe, Ann Sophie Schröder, Axel Pruss, Kai M. Hourfar, Ulrich Kalus, Yvonne Scharnagl, Jan Claas Brune, Carolin Edler, Steffi Grosch, Uwe Hesselbarth, Dimitri Nowack, Katja Müller, Georg Wittmann, Axel Heinemann, Susanne Polywka, Rüdiger von Versen, Andreas Karl, Dirk Seifert, Klaus Püschel, Erhard Seifried, Hans-Joachim Mönig, Thomas Meyer, Ina Wilkemeyer, and Philipp Seifert
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Immunology and Allergy ,Hematology - Published
- 2012
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23. Improved Detection of Bacterial Central Nervous System Infections by Use of a Broad-Range PCR Assay
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Susanne Polywka, Gefion Franke, Marc Lütgehetmann, Martin Aepfelbacher, Thomas Meyer, Tim Magnus, and J. Gbadamosi
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DNA, Bacterial ,Microbiology (medical) ,Bacteria ,biology ,Central nervous system ,Pcr assay ,Bacteriology ,Bacterial Infections ,Standard methods ,medicine.disease ,biology.organism_classification ,Polymerase Chain Reaction ,Virology ,Meningitis, Bacterial ,Microbiology ,Central Nervous System Infections ,Infective Meningitis ,medicine.anatomical_structure ,Cerebrospinal fluid ,medicine ,Humans ,Detection rate ,Meningitis - Abstract
A universal PCR assay for bacteria and fungi detected meningitis pathogens in 65% of 20 cerebrospinal fluid (CSF) samples from patients with suspected central nervous system (CNS) infections compared to a 35% detection rate by culture and/or microscopy methods. Thus, the PCR assay can improve the diagnosis rate of infective meningitis when standard methods provide a negative result.
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- 2014
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24. Verlauf von HEV-Virämie und anti-HEV IgM/IgG-Antwort bei 27 immunkompetenten Blutspendern
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C Kraef, Jens Hiller, S. Pischke, C Schlein, AW Lohse, Thomas Horvatits, U Denzer, Susanne Polywka, M. Luetgehetmann, Sven Peine, and D. Westhölter
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Gastroenterology - Published
- 2018
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25. Blood products as source of HEV transmission? 1-year experience with routine HEV screening at a tertiary center
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AW Lohse, Thomas Horvatits, S. Pischke, D. Westhölter, Jens Hiller, Susanne Polywka, Ulrike W. Denzer, M. Luetgehmann, and P. Sven
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Transmission (mechanics) ,Hepatology ,business.industry ,law ,Medicine ,Center (algebra and category theory) ,Medical emergency ,business ,medicine.disease ,law.invention - Published
- 2018
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26. Hepatitis B-Diagnostik bei Blutspendern: Verfahren und Interpretation auffälliger Befundkonstellationen. Diagnosis of hepatitis B in blood donors: procedure and interpretation of suspicious results
- Author
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Susanne Polywka
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Medical Laboratory Technology ,business.industry ,Interpretation (philosophy) ,Biochemistry (medical) ,Clinical Biochemistry ,Immunology ,Hepatitis B virus HBV ,medicine ,virus diseases ,Hepatitis B ,medicine.disease ,business ,digestive system diseases - Abstract
Several test systems are available for the diagnosis of infection with the hepatitis B virus (HBV). In most cases, reliable results lead to the detection of acute infection or chronic HBV infection or immunity due to past infection or active immunization. In some cases, however, results may be difficult to interpret or even misleading and special assays are necessary to answer more specific questions. During acute or chronic HBV infection, not only the qualitative detection of HBsAg is necessary, but also the quantitative determination may allow for the diagnosis of activity of the disease. In most cases, HBeAg closely correlates to viraemia and infectivity, but mutations within the pre-core region of the HBV genome may lead to a loss of HBeAg and to seroconversion to anti-HBe while the virus concentration in serum is high and patients are severely ill. Anti-HBc assays often give false positive test results which can be ruled out by re-testing a serum dilution. IgM antibodies against HBcAg are not only found during acute infection but may become positive again during reactivation in chronic virus carriers. Different genotypes of the virus are prevalent in different parts of the world and multiple infections are possible; these may lead to the simultaneous detection of HBsAg and anti-HBs. Viral DNA can be detected by several methods with different lower detection limits. Screening of blood donors to rule out HBsAg-negative virus carriers is done by polymerase chain reaction, since this method has the highest sensitivity. Infectivity of HBsAg-positive carriers may also be determined by other assays such as branched DNA or molecular hybridization. Patients on treatment with nucleoside analogs may show an increase in DNA concentration after an initial decrease or even loss. This may be due to mutation within the YMDD-motif of the DNA polymerase which can be detected by sequence analysis. In this overview, hints will be given on how to evaluate positive results in the different assays. In addition, it gives advice on how to establish a suitable diagnosis for a variety of clinical questions. Several suspicious constellations are discussed as well as the possibilities to clarify them.
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- 2005
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27. Diagnostische Verfahren bei der Hepatitis C und ihre Zuverlässigkeit. Reliability of diagnostic procedures for hepatitis C
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Susanne Polywka
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Gynecology ,Medical Laboratory Technology ,medicine.medical_specialty ,business.industry ,Biochemistry (medical) ,Clinical Biochemistry ,Medicine ,Seroconversion ,business - Abstract
The diagnosis of HCV infection is often hampered by false positive reactivities in antibody screening assays. Therefore, confirmatory assays are necessary. Since most unspecific reactivities are only slightly above the cut-off value, the intensity of the reactivity should always be considered. Particularly in groups with low HCV risk such as blood donors, positive reactivities obtained by one test system can often be ruled out by re-testing with another format (e.g. an enzyme immunoassay instead of a microparticle enzyme immunoassay). Most confirmatory assays are based on a recombinant immunoblot assay (RIBA); these tests should always be done in patients diagnosed as HCV positive for the first time. Additionally, in many cases, tests for HCV RNA are necessary. Based on these results, an evaluation of the risk of transmission to household contacts is possible and in patients receiving antiviral treatment, the success can be monitored. A negative PCR result in patients showing high positive antibody reactivities does not necessarily represent loss of the virus since even in chronic carriers, viral replication can be intermittently very low. Immuno-compromised patients often show prolonged seroconversion so that antibody screening assays remain negative for a long time while the patients have high level viraemia. Therefore, we recommend regular RT-PCR in populations at risk such as patients on chronic dialysis. To evaluate patients for antiviral treatment, the determination of the genotype is necessary. The HCV genotype also has an influence on the course of liver disease in chronic carriers. Possible transmission of HCV, e.g. by blood products, can be elucidated by sequence analysis of the high variance region (HVR) of the virus.
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- 2005
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28. Blood-borne HEV transmission: first experience with global HEV screening at a tertiary center
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Sven Peine, D. Westhölter, Marc Lütgehetmann, AW Lohse, Ulrike W. Denzer, Jens Hiller, Susanne Polywka, and Sven Pischke
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Geography ,Transmission (mechanics) ,Hepatology ,law ,medicine ,Center (algebra and category theory) ,Medical emergency ,medicine.disease ,law.invention - Published
- 2017
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29. Breadth of the HCV-specific CD4+ T-cell response in spontaneous resolvers is independent of the IL-28 haplotype
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Georg M. Lauer, C. Scheurich, Arthur Y. Kim, R.T. Chung, T. Meyer, Susanne Polywka, J Schulze zur Wiesch, and Lia Laura Lewis-Ximenez
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CD4-Positive T-Lymphocytes ,Genetics ,Hepatology ,Cd4 t cell ,business.industry ,Haplotype ,Hepacivirus ,Hepatitis C, Chronic ,Biology ,Hepatitis C ,Interferon-gamma ,03 medical and health sciences ,0302 clinical medicine ,Infectious Diseases ,Text mining ,Haplotypes ,Virology ,Humans ,030211 gastroenterology & hepatology ,030212 general & internal medicine ,business - Published
- 2016
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30. Contents Vol. 39, 2012
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Yvonne Scharnagl, Jan Claas Brune, Klaus Püschel, Erhard Seifried, Uwe Hesselbarth, Rüdiger von Versen, Torsten Tonn, Axel Pruss, Hans-Joachim Mönig, Michael Schmidt, Katja Müller, Dirk Seifert, Georg Wittmann, Ulrich Kalus, Birgit Wulff, Knut Gubbe, Reinhold A. Schiller, Kai M. Hourfar, Jan Schroeter, Frithjof Herrlinger, Andreas Karl, Ann Sophie Schröder, Susanne Polywka, Mark David Smith, Dimitri Nowack, Carolin Edler, Steffi Grosch, Philipp Seifert, Axel Heinemann, Ralf Knels, Ina Wilkemeyer, and Thomas Meyer
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Immunology and Allergy ,Hematology - Published
- 2012
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31. Inhalt Band 39, 2012
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Michael Schmidt, Axel Heinemann, Carolin Edler, Steffi Grosch, Axel Pruss, Knut Gubbe, Ulrich Kalus, Katja Müller, Dirk Seifert, Klaus Püschel, Erhard Seifried, Reinhold A. Schiller, Birgit Wulff, Torsten Tonn, Yvonne Scharnagl, Susanne Polywka, Uwe Hesselbarth, Rüdiger von Versen, Jan Schroeter, Frithjof Herrlinger, Dimitri Nowack, Hans-Joachim Mönig, Ann Sophie Schröder, Mark David Smith, Jan Claas Brune, Kai M. Hourfar, Ralf Knels, Andreas Karl, Georg Wittmann, Ina Wilkemeyer, Thomas Meyer, and Philipp Seifert
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Immunology and Allergy ,Hematology - Published
- 2012
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32. Human liver chimeric mice as a new model of Hepatitis E Virus infection and preclinical drug evaluation
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Susanne Polywka, S. Gass, AW Lohse, Jörg Petersen, Tassilo Volz, M Dandri, Katja Giersch, Sven Pischke, Marc Lütgehetmann, and Lena Allweiss
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Drug ,Human liver ,business.industry ,media_common.quotation_subject ,Immunology ,Gastroenterology ,Medicine ,business ,Virology ,Hepatitis E virus infection ,media_common - Published
- 2015
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33. Inter-laboratory comparison of HCV-RNA assay results: Implications for multi-centre research
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Isabella Quinti, Gustavo Cilla, Luciano Balbo, Maria Grazia Meliconi, A Alfarano, Anders Sönnerborg, Giuliano Furlini, Harry van Drimmelen, Paolo Laccetti, Silvia Galli, Sheila Burns, Marie-Louise Newell, Lucy Pembrey, Susanne Polywka, Nick Hallam, Giancarlo Icardi, Esther Serrano, Giuseppe Portella, Bianca Bruzzone, and Pier-Angelo Tovo
- Subjects
Infectious Diseases ,Multicenter study ,Serial dilution ,business.industry ,Virology ,Quantitative assay ,Medicine ,Round robin test ,Multi centre ,Inter-laboratory ,business - Abstract
To investigate whether it is appropriate to assume comparability of hepatitis virus C (HCV)-RNA results across laboratories in multi-centre studies, nine laboratories of the European Paediatric HCV Network participated in an international proficiency study of HCV-RNA assays. A panel of 12 samples of different dilutions and genotypes was sent to each laboratory and tested with qualitative and/or quantitative HCV-RNA assays according to local procedures. Commercial assays were used in seven laboratories and in-house assays in two. All six laboratories in which a commercial qualitative assay was used were proficient, as were four of six runs (in five laboratories) in which a commercial quantitative assay was used. The proficiency of the laboratories where in-house assays were used could not be assessed according to the VQC definition because of differences in the methods used. Overall, there were several false-negative results, but only one false-positive result with a quantitative assay and none with a qualitative assay. The false-negative results may have implications for the diagnosis of infection, and highlight the need for an antibody test to be performed at 18 months to confirm the absence of infection. The results of qualitative assays were generally consistent across laboratories but it was difficult to evaluate and compare the results of quantitative assays. Multivariate analysis of data collected in multi-centre studies should therefore allow for centre and/or assay used.
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- 2002
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34. Effective Immune Transfer, along with Induction of Rejection, Are Consequences of Using Grafts from Highly Immunized Donors
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Jun Li, O. Dirsch, Uta Dahmen, S. L. Jensen, L. Doebel, Christoph E. Broelsch, Andrea Frilling, Susanne Polywka, and T. Tanigawa
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Transplantation ,Immune system ,business.industry ,Immunology ,Medicine ,business - Published
- 2002
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35. Diagnostik der Hepatitis-C-Virusinfektion: Die Bedeutung von Bestätigungstesten*
- Author
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Heinz-Hubert Feucht, Susanne Polywka, Rainer Laufs, and Matthias Schröter
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Psychiatry and Mental health ,business.industry ,Medicine ,Hepatitis C ,business ,medicine.disease ,Virology ,Applied Psychology - Published
- 2002
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36. An unusual cause of elevated liver function tests in an elderly female
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Jonas Schmidt-Chanasit, Hagen Frickmann, Martin Gabriel, Susanne Polywka, Insa Bonow, and Stephan Günther
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Radiography, Abdominal ,medicine.medical_specialty ,Pathology ,Genotype ,medicine.medical_treatment ,Molecular Sequence Data ,Asymptomatic ,Gastroenterology ,chemistry.chemical_compound ,Liver Function Tests ,Virology ,Diabetes mellitus ,Internal medicine ,Hepatitis E virus ,medicine ,Cluster Analysis ,Humans ,Enalapril ,Metoprolol ,Aged, 80 and over ,Aspirin ,business.industry ,Liver Diseases ,Insulin ,Furosemide ,Sequence Analysis, DNA ,medicine.disease ,Enzymes ,Hepatitis E ,Infectious Diseases ,Liver ,chemistry ,Asymptomatic Diseases ,Spironolactone ,RNA, Viral ,Female ,medicine.symptom ,Tomography, X-Ray Computed ,business ,medicine.drug - Abstract
An 84-years-old female patient was admitted to a hospital rom a nursing home in Hamburg (Germany) for the optimization f her insulin regimen for diabetes mellitus type 2. She further uffered from coronary heart disease, heart insufficiency NYHA II, cardiac arrhythmia, malignant melanoma, chronic obstructive ung disease, dementia and hypothyreosis. Her daily medication omprised a fixed insulin scheme, simvastatin, aspirin, clopidorel, molsidomine, digitoxin, metoprolol, enalapril, furosemide, ydrochlorothiazide, spironolactone, pantoprazole, allopurinol, evothyroxine, oxazepam, acetylcysteine, as well as inhaled foroterol. She had signs of diabetic polyneuropathia and was obese body mass index 31). Routine clinical laboratory investigations demonstrated eleated levels of c-reactive protein (CRP) of 38.1mg/l (
- Published
- 2011
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37. Relevance of chronic hepatitis E in liver transplant recipients: a real-life setting
- Author
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A Galante, Sven Pischke, Jens Hiller, Susanne Polywka, Martina Sterneck, M. Luetgehethmann, Ansgar W. Lohse, Hans Peter Dienes, A. Gisa, Bjoern Nashan, and Pothakamuri Venkata Suneetha
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Renal function ,Chronic liver disease ,medicine.disease_cause ,Gastroenterology ,Antiviral Agents ,Transaminase ,chemistry.chemical_compound ,Young Adult ,Postoperative Complications ,Hepatitis E virus ,Internal medicine ,Ribavirin ,medicine ,Humans ,Prospective Studies ,Aged ,Hepatitis, Chronic ,Transplantation ,medicine.diagnostic_test ,biology ,business.industry ,Middle Aged ,medicine.disease ,Hepatitis E ,Liver Transplantation ,Infectious Diseases ,Treatment Outcome ,chemistry ,Alanine transaminase ,Liver biopsy ,Immunology ,biology.protein ,Female ,business - Abstract
The chronic course of hepatitis E virus (HEV) infections in orthotopic liver transplant (OLT) recipients has been described previously, but prospectively collected data are rare. We aimed to study the role of chronic hepatitis E in OLT in a real-life setting. Therefore, 287 adult OLT recipients (169 male [59%], median age 56 years) were prospectively tested by HEV polymerase chain reaction assay (lower level of detection = 10 IU/mL), irrespective of their level of liver enzymes. In 4 patients (1.4%), chronic HEV infection was diagnosed. All 4 patients were male, and their age (median 48.5 years), the time since transplantation (median 45.5 months), and bilirubin level (median 0.6 mg/dL) did not differ significantly from the total cohort. However, alanine transaminase and aspartame transaminase levels were significantly higher in HEV-infected patients (75-646 U/L, median 216 U/L and 68-317 U/L, median 108 U/L) than in non-infected patients (6-617 U/L, median 41 and 6-355 U/L, median 36; P = 0.004 and 0.040, Mann-Whitney test). In 3 patients, liver biopsy was performed and revealed signs of inflammation and chronic liver disease, as enlarged densely infiltrated portal tracts with mild-to-moderate interface hepatitis. All infected patients were treated with ribavirin with the starting dose adjusted to renal function (400-800 mg/day). In 2 patients, dose reduction was necessary. Transaminases normalized in all 4 patients, and all patients cleared their infection within 3 months of ribavirin treatment. However, 1 patient experienced viral relapse 12 weeks after discontinuation. Ribavirin medication was re-started and viral clearance occurred within 8 weeks and persisted. Sequence analysis of the HEV genome of this patient revealed that he was infected with an HEV variant, which recently has been shown to have a reduced response to ribavirin in cell culture. The risk of chronic HEV infections in OLT recipients in low-endemic countries should not be overestimated. No case of chronic hepatitis E was observed in patients with normal liver enzymes, indicating that general screening of all OLT recipients is not necessary. However, if chronic hepatitis E develops, it can be treated efficiently with ribavirin.
- Published
- 2014
38. Age-Dependent Acquisition of Hepatitis G Virus/GB Virus C in a Nonrisk Population: Detection of the Virus by Antibodies
- Author
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Matthias Schröter, Susanne Polywka, Rainer Laufs, Heinz-Hubert Feucht, and Bernhard Zöllner
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Adult ,Male ,Microbiology (medical) ,Adolescent ,Hepatitis, Viral, Human ,Population ,Viremia ,Virus ,Serology ,Seroepidemiologic Studies ,Virology ,Humans ,Medicine ,Seroprevalence ,Hepatitis Antibodies ,Child ,education ,Aged ,Hepatitis ,education.field_of_study ,biology ,business.industry ,Flaviviridae ,Age Factors ,virus diseases ,Middle Aged ,biology.organism_classification ,medicine.disease ,GB virus C ,digestive system diseases ,Child, Preschool ,Immunology ,Female ,Viral disease ,business - Abstract
Until now there have been few seroepidemiological data for hepatitis G virus/GB virus type C (HGV/GBV-C). A four-antigen HGV/GBV-C immunoblot was established to examine 446 serum specimens from healthy individuals without risk factors for parenteral viral transmission. These individuals were divided into seven groups according to age. Seroprevalence rates were low for children and adolescents (5.6%) and increased for the age groups assumed to be the most sexually active (15.3 to 26.8%). Remarkably, none of the 80 individuals who tested positive for HGV/GBV-C antibodies were simultaneously positive for HGV/GBV-C viremia. From our data we conclude that HGV/GBV-C infection is widespread in the general population (16 to 25%). The development of an antibody response is associated with clearance of HGV/GBV-C viremia. Due to the lack of risk factors for HGV/GBV-C infection of blood, other efficient transmission routes must exist. It must be assumed that HGV/GBV-C transmission may be linked to sexual activity.
- Published
- 1999
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39. Definition of Chronic Hepatitis E After Liver Transplant Conforms to Convention
- Author
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Martina Sterneck, Björn Nashan, Ansgar W. Lohse, Markus Memmler, Sven Pischke, Susanne Polywka, and Sebastian Meisner
- Subjects
Transplantation ,medicine.medical_specialty ,Pathology ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Liver transplantation ,medicine.disease_cause ,Hepatitis E ,medicine.disease ,Convention ,Hepatitis E virus ,medicine ,Budd–Chiari syndrome ,Immunology and Allergy ,Pharmacology (medical) ,Chronic hepatitis E ,business ,Intensive care medicine ,Liver function tests ,Viral load - Published
- 2015
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40. P0554 : Hepatitis E virus infection induces an innate immune response in human chimeric mice
- Author
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Jörg Petersen, Katja Giersch, J Kah, Maura Dandri, Lena Allweiss, Marc Lütgehetmann, S. Gass, Ansgar W. Lohse, Tassilo Volz, Susanne Polywka, and Sven Pischke
- Subjects
Innate immune system ,Hepatology ,Biology ,Virology ,Hepatitis E virus infection - Published
- 2015
- Full Text
- View/download PDF
41. P0748 : Course of HCV RNA and HCV core antigen testing are predictors for reaching SVR in transplant recipients
- Author
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S. Stauga, Sven Pischke, AW Lohse, S. Meisner, Sabine Jordan, M. Lang, M Sterneck, Susanne Polywka, and Bjoern Nashan
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Hepatology ,business.industry ,Medicine ,Hcv core antigen ,business ,Virology - Published
- 2015
- Full Text
- View/download PDF
42. Distribution of hepatitis G viremia and antibody response to recombinant proteins with special regard to risk factors in 709 patients
- Author
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Bernhard Zöllner, Heinz-Hubert Feucht, H Nolte, Rainer Laufs, Matthias Schröter, Susanne Polywka, and B. Knödler
- Subjects
Adult ,Male ,Adolescent ,Hepatitis, Viral, Human ,Hepatitis C virus ,Immunoblotting ,Population ,Viremia ,Antibodies, Viral ,medicine.disease_cause ,Polymerase Chain Reaction ,Serology ,Viral Proteins ,Risk Factors ,medicine ,Humans ,Risk factor ,education ,Aged ,Hepatitis ,education.field_of_study ,Hepatology ,biology ,business.industry ,Flaviviridae ,virus diseases ,Middle Aged ,medicine.disease ,Virology ,Recombinant Proteins ,digestive system diseases ,Alanine transaminase ,Immunology ,biology.protein ,Female ,Viral disease ,business - Abstract
A new virus named hepatitis G virus (HGV) has been detected recently. Until now, no assays for the detection of antibodies against different HGV proteins have been commercially available. Therefore, a strip immunoblot assay has been established to investigate seroreactivity against recombinant structural (core) and nonstructural proteins (NS3 and NS4) of HGV produced in Escherichia coli. Seropositivity for HGV was evaluated and concordanced with HGV polymerase chain reaction (PCR) results in 709 subjects. These individuals were classified into a nonrisk or a risk group, on the basis of infection with human immunodeficiency virus (HIV) or hepatitis C virus (HCV) or frequent parenteral exposure, including hemophilia, intravenous drug addiction, receipt of blood transfusion, or hemodialysis. The nonrisk group consisted of 257 healthy blood donors with normal alanine transaminase (ALT) levels (ALT30 U/L) and 154 patients with suspected non-A-E hepatitis (ALT45 U/L). In the group of healthy blood donors, 1.9% (5 of 257) had detectable HGV viremia and 15.9% (41 of 257) showed antibody response to HGV. In the collective of patients with suspected non-A-E hepatitis, results from 1.9% of patients (3 of 154) were positive by HGV PCR, and 15.6% of patients (24 of 154) showed seropositivity against the recombinant HGV proteins. In six groups of patients (n = 298) with different risk factors, the prevalence of both HGV viremia (V) and serological reactivity (SR) was higher compared with that of the nonrisk group: V, 6.80%-35.2%; serological reactivity (SR), 25.4%-52.9%. The following conclusions can be derived from our data. HGV infection is widespread in the general population. The prevalence of antibodies against HGV or detectable HGV viremia is higher in patients with risk factors for parenteral viral transmission than in those without risk factors. The majority of HGV infections (70.2%) is self-limiting and not persistent in our collective of patients. We found no correlation between HGV viremia and clinical or biochemical signs of hepatitis in individuals without risk factors for acquiring parenterally transmitted agents.
- Published
- 1997
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43. The Influence of Age on the Prevalence of Hepatitis C Virus Subtypes 1a and 1b
- Author
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Hartmut Nolte, Bernhard Zöllner, Heinz-Hubert Feucht, Rainer Laufs, Matthias Schröter, and Susanne Polywka
- Subjects
Adult ,Male ,Time Factors ,Hepatitis C virus ,Molecular Sequence Data ,Population ,Hepacivirus ,Biology ,medicine.disease_cause ,Virus ,Flaviviridae ,Risk Factors ,Germany ,Genotype ,medicine ,Humans ,Immunology and Allergy ,Risk factor ,education ,Aged ,Diminution ,education.field_of_study ,Base Sequence ,Age Factors ,Interferon-alpha ,Middle Aged ,biology.organism_classification ,Hepatitis C ,Virology ,Infectious Diseases ,RNA, Viral ,Female ,Viral disease - Abstract
The distribution of hepatitis C virus (HCV) genotypes was determined in isolates of 447 chronically HCV-infected German patients by nucleotide sequencing. Of these, 206 (46.1%) were infected with the subtype 1a, 215 (48.1%) with subtype 1b, 2 (0.4%) with subtype 1c, 9 (2.0%) with subtype 3a, and 15 (3.4%) with subtype 4a. Subtype 1a was predominant in those40 years old (62.6%) and was associated with the risk factor of intravenous drug addiction and with shorter duration of disease. Conversely, subtype 1b was more frequent in patients50 years old (84.7%; P.001) and was associated with the risk factor of blood transfusions and with longer duration of disease. These data suggest that a shift from subtype 1b to subtype 1a occurred in the population studied. An increase in HCV infection with subtype 1a and a diminution of subtype 1b in the future can be expected.
- Published
- 1997
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44. Prolonged Time until Seroconversion among Hemodialysis Patients: The Need for HCV PCR
- Author
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Matthias Schroeter, Heinz-Hubert Feucht, Rainer Laufs, Bernhard Zoellner, and Susanne Polywka
- Subjects
Adult ,Time Factors ,Adolescent ,medicine.medical_treatment ,Hepatitis C virus ,Hepacivirus ,medicine.disease_cause ,Polymerase Chain Reaction ,law.invention ,Renal Dialysis ,law ,Virology ,medicine ,Humans ,Seroconversion ,Child ,Polymerase chain reaction ,Aged ,Aged, 80 and over ,business.industry ,virus diseases ,Maintenance hemodialysis ,Hepatitis C Antibodies ,Middle Aged ,Hepatitis C ,digestive system diseases ,Infectious Diseases ,Hemodialysis ,business - Abstract
Objective: Patients on maintenance hemodialysis are known to have an elevated risk of acquiring hepatitis C virus (HCV) infection. Therefore, a reliable diagnosis of HCV infection is essential in order to prevent the spread of the disease in dialysis units. However, whether PCR examination is dispensable in hemodialysis patients has been debated. Methods: From 1995 to 2002, serum samples from all hemodialysis patients at our hospital (n = 1,774) were screened by serological assays and by polymerase chain reaction (PCR). Results: In 25 of these patients acute HCV infection was observed and in 11 patients HCV seroconversion was delayed for 3–16 months. During this time the infection was exclusively detectable by PCR. Conclusion: Despite the growing demand for cost-effectiveness in the health system, HCV PCR examination must remain an essential part of the routine screening in hemodialysis patients.
- Published
- 2005
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45. Viral hepatitis in alcohol-dependent inpatients: prevalence, risk factors, and treatment uptake
- Author
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Stefan Lüth, Daniela Schön, Christiane Sybille Schmidt, Jens Reimer, Bernd Schulte, and Susanne Polywka
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Adult ,Male ,medicine.medical_specialty ,Hepatitis B virus ,Hepatitis C virus ,Population ,Hepacivirus ,medicine.disease_cause ,Antiviral Agents ,Serology ,Medication Adherence ,Liver Function Tests ,Risk Factors ,Internal medicine ,Germany ,Epidemiology ,medicine ,Prevalence ,Humans ,Mass Screening ,Pharmacology (medical) ,Serologic Tests ,education ,education.field_of_study ,business.industry ,Alcohol dependence ,Middle Aged ,medicine.disease ,Hepatitis B ,Hepatitis C ,Confidence interval ,Psychiatry and Mental health ,Alcoholism ,Female ,business ,Viral hepatitis ,Biomarkers - Abstract
OBJECTIVES Most epidemiological literature on the prevalence of viral hepatitis in alcohol-dependent patients is based on older data. This study aimed to provide current estimates and an assessment of risk factors. We further investigated whether the initiation of antiviral hepatitis C virus (HCV) treatment is feasible after detoxification. METHODS We assessed serological markers for hepatitis B virus (HBV) and HCV infection and liver enzyme levels (alanine aminotransferase, aspartate aminotransferase, γ-glutamyltransferase) in a sample of 463 inpatients in a tertiary care hospital, fulfilling International Classification of Diseases, Tenth Revision criteria for alcohol dependence. A subsample of 141 patients was interviewed on addiction history and risk factors for HCV acquisition. All patients with an indication for antiviral treatment were followed up. RESULTS Compared with that in the general population, we found an elevated anti-HCV prevalence in alcohol-dependent patients (5.2%; 95% confidence interval, 3.2%-7.2%), whereas anti-Hbc immunoglobulin G prevalence (8.3%; 95% confidence interval, 5.7%-10.8%) corresponded to normal rates. Liver enzyme levels significantly differed between patients with chronic, past/remitted, or no HCV infection. On an observational level, a history of injection drug use or nonprofessional tattooing emerged as potential risk factors. In 1 of 10 patients, antiviral therapy was initiated. This 1 patient achieved the end-of-treatment response after extended rapid virological response, despite continuous alcohol consumption. CONCLUSIONS The elevated HCV infection rates in our sample and the higher levels of fibrosis biomarkers in those with positive polymerase chain reaction corroborate previous findings and emphasize the importance of HCV screening in this population, particularly if further risk factors like injection drug use are given. Factors influencing treatment reluctance and conditions that may enhance the feasibility of antiviral treatment in alcohol-dependent patients should be subject of further research.
- Published
- 2013
46. Is rapid hepatitis C virus testing from corpses a screening option for index persons who have died after mass-casualty incidents in high-prevalence settings in the field?
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R. M. Hagen, Norbert Georg Schwarz, Ulrike Loderstaedt, Susanne Polywka, Hagen Frickmann, I Fengler, and B Wulff
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medicine.medical_specialty ,Time Factors ,Hepatitis C virus ,education ,medicine.disease_cause ,Serology ,Predictive Value of Tests ,Internal medicine ,medicine ,Cadaver ,Prevalence ,Humans ,Mass Casualty Incidents ,Mass Screening ,Serologic Tests ,Military Medicine ,Mass screening ,High prevalence ,business.industry ,Reproducibility of Results ,General Medicine ,Hepatitis C ,Hepatitis C Antibodies ,medicine.disease ,3. Good health ,Surgery ,Mass-casualty incident ,Predictive value of tests ,Autopsy ,business ,Weakly-reactive - Abstract
Introduction We tested a commercially available rapid hepatitis C virus (HCV) test assay for its potential use for analyses of corpses as a screening option for index persons who have died after mass-casualty incidents in high-prevalence settings in the field. Materials and methods 50 blood samples were drawn from 16 recently deceased confirmed HCV-positive patients whose corpses were stored at 4°C in the mortuary and were analysed at admission and up to 48 h post mortem by rapid serological testing using the ImmunoFlow HCV test (Core Diagnostics, Birmingham, UK) in comparison with automated serological assays and PCR. Samples from 50 HCV-negative corpses were also analysed. Results The blood of only four of the 16 HCV-positive corpses reacted clearly with the ImmunoFlow HCV test, while in five cases the result was only weakly reactive and three cases showed very weak reactivity. Four of the infected corpses showed initially negative results, three of which became very weakly reactive 48 h post mortem. 49 out of 50 samples (98%) from HCV-negative corpses tested negative. Discussion The rapid test system we investigated showed insufficient sensitivity regarding the identification of HCV positivity. Automated serological testing or PCR should be preferred if it is realistically available in the deployed military setting.
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- 2013
47. Persistent hepatitis D virus mono-infection in humanized mice is efficiently converted by hepatitis B virus to a productive co-infection
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Jörg Petersen, Marc Lütgehetmann, Ansgar W. Lohse, Susanne Polywka, Lena Allweiss, Katja Giersch, John M. Taylor, J. M. Pollok, Maura Dandri, Lida V. Mancke, Tassilo Volz, and Martina Helbig
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HBsAg ,Hepatitis B virus ,viruses ,Molecular Sequence Data ,Viremia ,Biology ,medicine.disease_cause ,Virus Replication ,Virus ,Mice ,medicine ,Animals ,Humans ,Hepatology ,Base Sequence ,Coinfection ,virus diseases ,cccDNA ,biochemical phenomena, metabolism, and nutrition ,medicine.disease ,Hepatitis B ,Virology ,Hepatitis D ,HBcAg ,Immunology ,Hepatitis D virus ,Hepatitis Delta Virus ,Viral load - Abstract
Background & Aims: Clinical studies have shown that hepatitis delta virus (HDV) infection can persist for years and intrahepatic latency of the large delta antigen (HDAg) has been detected following liver transplantation. However, large HDAg arising via RNA-editing is associated with increasing amounts of non-infectious HDV quasispecies. This study investigated whether HDV could persist intrahepatically in the absence of HBV in vivo and whether infectious HDV could subsequently be released following HBV super-infection. Methods: Humanized mice were infected with HDV particles lacking HBV. To test for rescue of latent HDV infection 3 and 6 weeks HDV mono-infected mice were super-infected with HBV. Viral loads and cell toxicity were determined by qRT-PCR and immunohistochemistry. Results: The presence of HDAg-positive human hepatocytes determined after 2, 3, and 6 weeks of HDV inoculation demonstrated establishment and maintenance of intrahepatic HDV mono-infection. Although intrahepatic amounts of large HDAg and edited HDV RNA forms increased over time in HDV monoinfected livers, HBV super-infection led to prompt viremia development (up to 10 8 HDV RNA and 10 7 HBV-DNA copies/ml) even after 6 weeks of latent mono-infection. Concurrently, the number of HDAg-positive human hepatocytes increased, demonstrating intrahepatic HDV spreading. The infectivity of the rescued HDV virions was verified by serial passage in naive chimeric mice. Conclusions: HDV mono-infection can persist intrahepatically for at least 6 weeks before being rescued by HBV. Conversion of a latent HDV infection to a productive HBV/HDV co-infection may contribute to HDV persistence even in patients with low HBV replication and in the setting of liver transplantation. 2013 European Association for the Study of the Liver. Published
- Published
- 2013
48. Serum HBV pgRNA can serve as clinical marker for cccDNA activity in patients with HBV mono and HBV/HDV co-infection
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T. Nuurei, Maura Dandri, AW Lohse, Marc Lütgehetmann, JH Bockmann, Susanne Polywka, Katja Giersch, Lena Allweiss, and Tassilo Volz
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Hepatology ,business.industry ,Clinical marker ,cccDNA ,Virology ,03 medical and health sciences ,0302 clinical medicine ,Immunology ,Medicine ,030211 gastroenterology & hepatology ,In patient ,030212 general & internal medicine ,business ,Co infection - Published
- 2017
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49. Fine Characterization and Determination of Cross-Reactivity of HCV-specific CD4+ T Cell Epitopes
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Thomas Eiermann, J Schulze zur Wiesch, Silke Kummer, V Matzat, C Scheurich, AW Lohse, I Tóth, T. Meyer, Philip Hartjen, Susanne Polywka, and J van Lunzen
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T cell ,ELISPOT ,Haplotype ,Gastroenterology ,Priming (immunology) ,Biology ,medicine.disease_cause ,Virology ,Cross-reactivity ,Epitope ,medicine.anatomical_structure ,Immune system ,Immunology ,Genotype ,medicine - Abstract
Introduction: An important component of a successful immune response is a strong and durable CD4+ T cell response directed against multiple epitopes covering the whole HCV polyprotein. However, few HCV CD4+ epitopes have been characterized in detail so far. Here, we study a set of HCV CD4+ T cell specificities concerning their optimal length, HLA restriction and cross-genotype reactivity. Methods: HCV-specific CD4+ T cells from PBMC from 40 HCV patients with different disease outcome (15 spontaneous resolvers) and healthy controls were in vitro expanded with a set of 24 frequently targeted HCV genotype (GT) 1a 20mer peptides. Additionally online available HCV-sequences (www.hcvdb.org) were aligned and genotype specific-variants were made for a subset of the epitopes. CD4+ T cell responses were analyzed after 10 days of culture by ELISPOT and confirmed with intracellular cytokine staining for INF-γ after restimulation with GT-specific peptides. Additionally all patients with spontaneously resolved infection were serotyped for past exposure of HCV genotype 1–6. The IL28 haplotype as well as MHC class II molecules were determined in all patients. Results: As expected, the spontaneous resolvers show significantly more CD4+ responses (5 on average) against HCV-specific peptides than other patient groups including patients who show a sustained virological response after therapy (SVR). Testing with genotype specific peptide variants revealed varying response patterns which depend on the genotype the individual patient was exposed to. Conclusions: Cross-genotype reactivity can be observed for some CD4+ epitopes, but varying degrees of cross reactivity in individual patients might (among other variables) depend on the exact sequence of the priming hepatitis C virus(es). Literatur: Schulze zur Wiesch et al. Blood 2007 110:1559-1569
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- 2012
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50. Downregulation of CD73 surface expression in regulatory as well as effector T cells in chronic HCV infection
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Anh Q. Le, V Matzat, C Scheurich, C Frenzel, AW Lohse, Silke Kummer, J van Lunzen, Claudia Beisel, Stefan Lüth, J Schulze zur Wiesch, Adriana Thomssen, Susanne Polywka, I Tóth, and Philip Hartjen
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Downregulation and upregulation ,Effector ,Immunology ,Gastroenterology ,Surface expression ,Biology ,Cell biology - Published
- 2012
- Full Text
- View/download PDF
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