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Subjects undergoing hemodialysis have enhanced vulnerability to hepatitis C virus (HCV) infection due to invasive procedures and poor infection control practices. Early detection and treatment are essential to prevent cross-infection and mortality/morbidity. However, common use anti-HCV antibody tests lack the necessary accuracy, and alternative tests (e.g. core antigen detection kits) which are available need to be examined as a viable alternative. A total of 270 continuous serum samples were collected from patients undergoing dialysis within 15 months of study period. Sequentially, multiple tests were performed – immunochromatography-based rapid test, third-generation ELISA i.e. (anti-HCV antibody detection), fourth-generation ELISA (HCV antigen–antibody combined detection assay), and HCV RNA quantitative real time polymerase chain reaction (qPCR) assay. Diagnostic parameters of serological kits were compared in terms of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and so on. Statistical Package for the Social Sciences was used. HCV-combined core antigen–antibody assays performed better than other serological assays in reference to the gold standard HCV RNA. This fourth-generation assay yielded a Kappa value of 0.947 compared with the value of 0.747 and 0.619 for anti-HCV ELISA and rapid detection test. Other parameters such as sensitivity, specificity, PPV, NPV, and so on were also better for fourth-generation ELISA compared with third-generation ELISA and other serological assays. HCV RNA was negative in 7.3% of anti-HCV–positive patients and was detected in 11.4% of anti-HCV ELISA–negative patients. In about 1.6% of HCV RNA–positive cases, fourth-generation ELISA was negative and had low HCV viral load (650 IU/ml and below). Fourth generation ELISA detected additional 7.4% HCV positive cases (compared to third generation kits) and upon cost effective analyis, additional cost to be bear for the better detection (by fourth generation kit) was found to be only INR 27 per 1% increased case detection. In resource scant setup, screening and follow-up of patients undergoing hemodialysis can be performed by fourth-generation HCV ELISA (antigen–antibody combined assay) instead of the current practice of anti-HCV antibody ELISA. Better yield in detection rate will compensate for slight addition to costs. [ABSTRACT FROM AUTHOR]

The main cause of transfusion associated hepatitis, cirrhosis and hepatocellular carcinoma is HCV infection. The present research was carried out to investigate the outbreak extent of anti-HCV antibodies among healthy blood donors attending the transfusion department at Khartoum hospitals. 3000 volunteer healthy blood donors participated in a cross-sectional study. Rapid test method was applied and positive samples were approved with the ELISA (fourth generation). SPSS software version 26 was used for statistical analysis of data. 0.5% of the research population was detected to have anti-HCV antibody. Donors (all male) were between 19-46 years old with mean age (1.95± 0.421SD). 2545 (84.8%) were volunteer, 455 (15.1%) were family replacement donors, 11 (0.36%) were positive among volunteer group, and most of the participants (0.16%) who were diagnosed with hepatitis C antibodies had history of cupping. 2265 (75%) of donors had a history of jaundices; only 13 (0.6%) statistically carried antibodies against HCV (P value 0.012). Sudanese blood donors had a low seroprevalence of hepatitis C virus; however, the existence of the virus and the likelihood of transmission and dissemination were confirmed. Hence, very rigorous guidelines are necessary for selecting blood donors. Furthermore, laboratory diagnostic tests for identifying infectious agents must be significantly enhanced. [ABSTRACT FROM AUTHOR]

This present study was planned to obtain an up-to-date picture of Hepatitis C virus (HCV) infection and its genotypes distribution in Peshawar, Khyber Pakhtunkhwa, Pakistan, as well as of the relationship between HCV genotypes and demographic and clinical parameters, and the risk factors in patients with an HCV subtype. Samples (blood) from 1978 individuals were collected and were tested using a strip-based method called the immunochromatographic test (ICT) for the existence of antibodies against HCV. It was observed that 158 of the 1978 individuals (7.9%) harbored antibodies in their blood against HCV, among which the female percentage (53.2%) was higher than that of the male (46.8%). Among the different age groups, the highest number of incidences of HCV antibodies was found in the age group of 31–40 years (26.6%). ICT positive samples were further screened by polymerase chain reaction (PCR) to determine the existence of active HCV-RNA, and it was found that 6.21% (123) of the total population (1978) tested, was positive, among which the female rate (56.91%) was observed to be higher than that of the male (43.09%). The highest incidence recorded was in the age group of 41–50 years (33.3%). HCV RNA positive individuals were genotyped: genotype 3a (45.5%) was dominant among the other detected genotypes, followed by 1a (11.4%), 3b (4.9%), and 2a (4.1%). It was concluded that the highest prevalence of HCV was found in females, and that the dominant genotype of the screened individuals was 3a genotype.

Objectives: Hepatitis C Virus (HCV) infection is life threatening but with the advent of new antiviral agents is potentially curable. Its prevalence among healthy blood donors was estimated in Mayo Hospital, Lahore, Pakistan. The aim of this study was to help in estimating disease burden in addition to early diagnosis of asymptomatic individuals necessitating treatment. Study Design: Retrospective single centre cross-sectional study. Setting: Mayo Hospital, Lahore, Pakistan. Period: January 2016 to December 2017. Material and Methods: Blood donors were tested for Anti-HCV antibodies by qualitative test based on lateral flow immunoassay using commercially made rapid test kits. Results: In 2016 and 2017, a total of 76530 healthy blood donors were screened for anti-HCV antibodies. Out of 76530 donors, 2095 were found to have anti-HCV antibodies constituting cumulative percentage of 2.73%. The seroprevalence was 2.49% in 2016 and reached to 2.97% in 2017. Conclusion: Seroprevalence of Hepatitis C among healthy blood donors is quite high at 2.73% and has slightly increased in 2017 compared to 2016. This dictates need for continued community awareness for prevention, early detection, and treatment. This study will be helpful for health policy makers to design more effective strategic planning to eradicate Hepatitis C infection. [ABSTRACT FROM AUTHOR]

Background: Epidemiological characteristics of chronic hepatitis C virus (HCV) infection presented in the literature are not representative for the real situation with its incidence and prevalence in the Russian Federation. In the Moscow Region, which is the second largest population in the Russian Federation (7.2 million people), the Moscow Regional Registry of patients with hepatic disorders has been continuously maintained since 2010, as well as screening programs for anti-HCV positive individuals. Analysis of this data allows for generalization of the results obtain to the general population and for description of the prevalence of the infection among adult population of the Russian Federation. Aim: To analyze the epidemiological situation with chronic hepatitis C in the Moscow Region. Materials and methods: We analyzed data from the Moscow Regional Registry of patients with hepatic disorders as per April 2016, as well as the results of large scale screening of the population of the Moscow Region with oral express test for anti-HCV antibodies (OraQuick HСV Rapid Antibody Test). Based on the registry, we assessed the following parameters of the patient cohort with chronic HCV infection (n = 17 182): age, gender, HCV genotype, grade of liver fibrosis, allele variants of interleukin 28В. Within the large scale screening program among the population of the Moscow Region, 1447 individuals from 6 districts of the region were screened for anti-HCV antibodies. Results: As per April 2016, the proportion of patients with chronic viral hepatitis in the Registry was 75.3% (n = 12 938 of 17 182). The vast majority of them (80.3%, or n = 10 393) had chronic hepatitis C, with 84% (n = 8726) of referrals were patients of productive age (from 20 to 50 years). 8.4% (n = 873) of all HCV infected patients had liver cirrhosis. Although the proportion of patients with cirrhosis was negligibly low (< 1.5%) in patients below 30 years of age, it was progressively increasing with age, with a maximum of 23.8% in those above their 50-es. As far as the HCV genotype distribution is concerned, it was as follows: genotype 1, 54.1% (n = 5622) of patients, genotype 2, 7.2% (n = 747), genotype 3, 38.4% (n = 3990). According to the results of assessment of IL28B genetic polymorphisms (n = 3212), СС rs12979860, which is associated with the most favorable sensitivity to interferon α, was found in 27.5% (n = 883), СТ allele, in 58.4% (n = 1876), and ТТ in 14,1% (n = 453). Prevalence of HCV infection in the Moscow Region, assessed by the screening program, is 1.38% of adults, or 77 200 anti-HCV positive persons, whereas estimated number of patients with chronic hepatitis C may amount to 54 000 to 61 700. Conclusion: HCV infection is the most prevalent among other viral hepatites in the Moscow Region (80.3%), and the largest numbers of infected individuals are of productive age. Almost three quarters of these patients are referred for medical care at the stage of minimal liver injury, and antiviral therapy can be used on an elective basis. Knowing the proportion of patients with liver cirrhosis (8.4%) allows for planning of the need in emergency treatments. The true prevalence of HCV infection estimated from the results of the screening program is at least 5-fold higher than that in the Registry. This indicates the necessity to upgrade the system of primary assessments. In particular, it seems reasonable to include detection of anti-HCV antibodies into the list of obligatory screening laboratory tests.

Objectives: Regular blood transfusions are essential for patients with thalassaemia major. However, infections with hepatotropic viruses remain a major concern. The objective of this study was to evaluate the prevalence and characteristics of hepatitis C viral (HCV) infection among patients with homozygous beta thalassaemia in a single centre in Oman. Methods: A retrospective chart review of 200 patients treated at the Thalassemia Unit of Sultan Qaboos University Hospital (SQUH) in Muscat, Oman, between August 1991 and December 2011 was performed. Relevant demographic and clinical characteristics were collected, including age, gender, HCV status and the presence of endocrinopathies. Results: A total of 81 patients (41%) were found to be anti-HCV-antibody (anti-HCV)-positive. HCV ribonucleic acid tests were performed on 65 anti-HCV-positive patients and were positive among 33 (51%); the remaining 16 patients died before these tests were available. Anti-HCV-positive patients were significantly older than anti-HCV-negative patients (P

Background. Approximately 180 million persons (∼2.8%) globally are estimated to be infected by hepatitis C virus (HCV). HCV prevalence in Mexico has been estimated to be between 1.2 and 1.4%. The aim of present work was to determine the prevalence of HCV infection in patients and family members attending two primary care clinics in Puebla, Mexico.Material and methods. Patients and their accompanying family members in two clinics were invited to participate in this study between May and September 2010.Results. A total of 10,214 persons were included in the study; 120 (1.17%) persons were anti-HCV reactive. Of the reactive subjects, detection of viral RNA was determined in 114 subjects and 36 were positive (31%). The more frequent risk factors were having a family history of cirrhosis (33.1%) and having a blood transfusion prior to 1995 (29%). After a multiple logistic regression analysis only transfusion prior to 1995 resulted significant to HCV transmission (p = 0.004). The overall detected HCV genotypes were as follows: 1a (29%), 1b (48.5%), 2/2b (12.8%), and 3a (6.5%).Conclusion. The HCV prevalence in this population is in agreement with previous studies in other regions of Mexico.

Background. Patients exposed to hepatitis C virus (HCV) may develop chronic infection with viremia. The diagnosis of this condition requires the use of several laboratory tests in algorithms tailored to the population and resources available for each laboratory.Aim. We compared the diagnostic efficacy of two diagnostic algorithms for the identification of viremic patients with HCV. One based on confirmation of reactive antibody results with molecular techniques (reverse transcription polymerase chain reaction, RT-PCR) and the other based on the use of a new HCV core antigen test (HCV Ag).Material and methods. We measured levels of anti-HCV, HCV Ag and viral load (trough RT-PCR) in parallel, in 211 samples (53 antibody positive, 158 antibody negative). Using the three results available for each sample we simulated the diagnostic performance of the two algorithms and compared them to the results of RT-PCR as gold standard.Results. Both algorithms showed a high degree of concordance for viremic patients. The percentage of correctly classified patients was 99.05% for the algorithm based on RT-PCR and 98.10% for the HCV Ag algorithm. The HCV core Ag test showed a clinical sensitivity of 0.917 and showed a good correlation to the results of molecular biology. Spearman rank correlation coefficient (ρ) of 0.97 (95% CI 0.95 to 0.99, p < 0.0001). Conclusion. An algorithm incorporating HCV Ag as confirmatory test for anti-HCV results is a feasible alternative to the use of molecular techniques in laboratories that do not have access to them or require faster turn around times.

This present study was planned to obtain an up-to-date picture of Hepatitis C virus (HCV) infection and its genotypes distribution in Peshawar, Khyber Pakhtunkhwa, Pakistan, as well as of the relationship between HCV genotypes and demographic and clinical parameters, and the risk factors in patients with an HCV subtype. Samples (blood) from 1978 individuals were collected and were tested using a strip-based method called the immunochromatographic test (ICT) for the existence of antibodies against HCV. It was observed that 158 of the 1978 individuals (7.9%) harbored antibodies in their blood against HCV, among which the female percentage (53.2%) was higher than that of the male (46.8%). Among the different age groups, the highest number of incidences of HCV antibodies was found in the age group of 31–40 years (26.6%). ICT positive samples were further screened by polymerase chain reaction (PCR) to determine the existence of active HCV-RNA, and it was found that 6.21% (123) of the total population (1978) tested, was positive, among which the female rate (56.91%) was observed to be higher than that of the male (43.09%). The highest incidence recorded was in the age group of 41–50 years (33.3%). HCV RNA positive individuals were genotyped: genotype 3a (45.5%) was dominant among the other detected genotypes, followed by 1a (11.4%), 3b (4.9%), and 2a (4.1%). It was concluded that the highest prevalence of HCV was found in females, and that the dominant genotype of the screened individuals was 3a genotype. [ABSTRACT FROM AUTHOR]

Background: Haemodialysis (HD) patients are at an increased risk of Hepatitis C virus (HCV) infection, which is significantly associated with increased morbidity and mortality. Aim: The aim of this study was to find the prevalence of HCV infection in anti-HCV antibody negative haemodialysis patients by Real-time PCR (RT-PCR) and value of HCV-RNA among seronegative patients undergoing haemodialysis in a remotely located tertiary care hospital. Materials and Methods: A total of 100 chronic renal failure patients on haemodialysis were studied. All the patients were screened for anti-HCV antibodies by ELISA test and for HCVRNA by RT-PCR. Results: The overall prevalence of HCV infection was 32%. Antibody positivity was 30% and HCV-RNA by RT-PCR was detected in 20%. HCV-RNA in seronegative patients was detected in 2.8%. Conclusion: Serological assays (30%) are quite reliable for detecting HCV infection in patients undergoing haemodialysis in our tertiary care hospital. Only a small proportion of them (2.8%) require the documentation of viral genome for current infection.

Background: The aim of this prospective study was to determine the prevalence of HCV antibodies among pregnant women and their corresponding offspring in a tertiary medical centre in Southwestern Nigeria.Method: Anti-HCV antibodies (anti-HCV antibodies) were analyzed in blood samples from mothers and cord samples from their corresponding offspring using the Enzyme Linked Immunosorbent Assay (ELISA) method. The results obtained from the study were expressed in simple percentages.Results: Out of the 272 consenting pregnant women screened for anti-HCV antibodies, 25 (9.2%) of them were positive. As none of the pregnant women had multiple births, screening the 272 cord sera from their offspring for the same antibodies revealed that 3 (1.10%) of them were also positive. Thus, the prevalence of anti-HCV antibodies in the pregnant women and their offspring were 9.2% and 1.1% respectively.Conclusion: If vertical transmission of HCV were to be based on the acquisition of anti-HCV antibodies alone, the prevalence of vertical transmission from HCV infected mothers to offspring in the study was 12.0%. Further studies on vertical transmission are suggested to include analysis for HCV-RNA quantification in pregnant mothers and their offspring as well as a long-term follow-up of neonates seropositive for HCV markers. Such studies are necessary to justify any recommendations to be made for the purpose of reducing HCV infection through vertical transmission.

Purpose: Available estimates of the prevalence of chronic HCV infection in Italy are quite conflicting, varying from 1.5 to 22.5 %, with an apparent north to south gradient. As Direct Acting Antivirals are expensive, both National and local governmental Agencies are in urgent need of detailed and reliable estimates of HCV patients to be treated, nationwide and in each district. We investigated the prevalence of anti-HCV antibodies in a large unselected sample of surgical patients providing consent to in-hospital opt-out pre-surgical HCV screening, at two hospitals from the Abruzzo Region, Italy. Methods: Data were retrieved for 55,533 screened patients (4.1 % of the total population in the Abruzzo Region), admitted in the Orthopedic and General Surgery wards of Pescara and Teramo Hospitals from 1999 to 2014. Results: The prevalence of anti-HCV antibodies was 4.4 % in the total sample. HCV-positive patients had a mean age of 63.8 ± 19.9 years; 49.2 % were males. From 1999 to 2014, the prevalence of HCV antibodies decreased from 5.4 % to 4.1 %; at both sites, however, two age-related-peaks were evidenced, the first among patients aged 30-49 years, the second among those older than 70 years. Statistical analyses confirmed a significant trend to decrease over time and a higher prevalence in Pescara and among males (all p < 0.01). Conclusions: Data retrieved from opt-out pre-surgical screening programs may allow inexpensive and easy-to-perform estimates of HCV seroprevalence from large samples of unselected patients with a well-defined provenience, which may turn useful for future treatment resource allocation. [ABSTRACT FROM AUTHOR]

Objectives: Co-occurrence of oral lichen planus (OLP) and chronic hepatitis C virus (HCV) infection suggests a strong association, but the relation between mucocutaneus, autoimmune lichen planus and HCV infection remains unclear. In areas with higher prevalence of HCV infection in general population, like Japan and southern Europe, 20 to 40 % of patients with OLP test positive for anti-HCV antibodies, whereas in German populations, a co-occurrence of 4.2 to 16 % was reported. Material and methods: We screened 143 patients with histopathologically proven OLP for prevalence of anti-HCV antibodies. Additionally, we examined 51 anti-HCV-positive subjects with current or past HCV infection for clinical symptoms of OLP. In all patients, confirmatory diagnosis was made by the detection of HCV RNA via reverse transcription-polymerase chain reaction (RT-PCR). A randomized control group comprised 109 blood sera samples of patients without any characteristics of OLP. Results: The results of all patients showed no co-occurrence in either cohort. Conclusion: In conclusion, no association between oral lichen planus and chronic HCV infection in our study population was found. Clinical relevance: Anti-HCV antibody screening in patients with confirmed oral lichen planus is not indicated routinely in central Germany. [ABSTRACT FROM AUTHOR]

Patients with sickle-cell anemia submitted to frequent blood transfusions are at risk of contamination with hepatitis C virus (HCV). Determination of HCV RNA and genotype characterization are parameters that are relevant for the treatment of the viral infection. The objective of the present study was to determine the frequency of HCV infection and the positivity for HCV RNA and to identify the HCV genotype in patients with sickle-cell anemia with a history of blood transfusion who had been treated at the Hospital of the HEMOPE Foundation. Sera from 291 patients were tested for anti-HCV antibodies by ELISA 3.0 and RIBA 3.0 Chiron and for the presence of HCV RNA by RT-PCR. HCV genotyping was performed in 19 serum samples. Forty-one of 291 patients (14.1%) were anti-HCV positive by ELISA and RIBA. Both univariate and multivariate analysis showed a greater risk of anti-HCV positivity in those who had started a transfusion regime before 1992 and received more than 10 units of blood. Thirty-four of the anti-HCV-positive patients (34/41, 82.9%) were also HCV RNA positive. Univariate analysis, used to compare HCV RNA-negative and -positive patients, did not indicate a higher risk of HCV RNA positivity for any of the variables evaluated. The genotypes identified were 1b (63%), 1a (21%) and 3a (16%). A high prevalence of HCV infection was observed in our patients with sickle-cell anemia (14.1%) compared to the population in general (3%). In the literature, the frequency of HCV infection in sickle-cell anemia ranges from 2 to 30%. The serological screening for anti-HCV at blood banks after 1992 has contributed to a better control of the dissemination of HCV infection. Because of the predominance of genotype 1, these patients belong to a group requiring special treatment, with a probable indication of new therapeutic options against HCV.

The objectives of the present study were to assess the in vitro-induced anti-hepatitis C virus (HCV) antibody production (IVIAP) in relation to the clinical, biochemical, virologic and histologic variables of patients with HCV infection. The study included 57 patients (60% males) with HCV infection (anti-HCV and HCV-RNA positive). Alanine aminotransferase (ALT) was elevated in 89% of the patients. Mean viral load was 542,241 copies/ml and histology of the liver showed chronic hepatitis in 27/52 (52%) and cirrhosis in 11/52 (21%) patients. IVIAP levels were determined by immunoenzymatic assay at median absorbance of 0.781 at 450 nm. IVIAP was negative in 14% of the patients. When groups with IVIAP levels above and below the median were compared, high IVIAP levels were associated with the male sex, elevated ALT levels and more advanced disease stage. After logistic regression analysis, advanced histologic damage to the liver remained as the only independent variable associated with elevated IVIAP levels. Using a receiver operator characteristic curve, the best cut-off level for IVIAP was established (= 1.540), with 71% sensitivity and 94% specificity for the detection of more advanced disease stages (grades 3 and 4). These findings are consistent with the participation of immunological mechanisms in the genesis of the hepatic lesions induced by HCV and indicate that the IVIAP test may be useful as a noninvasive marker of liver damage either alone or in combination with other markers.

Introduction: Hepatitis B and C infections are a serious global public health problem. They are among the most significant hepatic infections leading to viral hepatitis and hepatocellular carcinoma. Blood or blood products are the important cause for the transmission of these diseases. Objective: To estimate the seroprevalence of Hepatitis B Surface antigen and antibodies to hepatitis C (Anti HCV Ab) in both sexes and different age groups, in a hospital based population in SRMS-IMS Bareilly. Method: 19002 & 15914 serum sample were collected over a period of one year from August 2012 to July 2013 from patients attending OPDs and admitted under various departments of SRMS-IMS Bareilly. Serum sample collected were tested for detection of HBsAg & Anti HCV antibodies by immunochromatographic assay (J.Mitra - rapid card tests). Results: In all 19002 serum samples were tested for HBsAg detection & 15914 serum samples for hepatitis C antibodies, over a period of one year. The seroprevalence of HBsAg was found to be 3.46%, & of Anti-HCV Ab as 2.12%. The seroprevalence of both HBsAg & Anti HCV antibodies are more in males as compare to females. Conclusion & Recommendation: The study throws light on the magnitude of viral infection in the hospital based patients in SRMS-IMS Bareilly, Uttar Pradesh and provides a reference for future studies. As blood is one of the most important cause of transmission of hepatitis B and C therefore safe blood transfusion, prevention of IV drug addiction & using sterilized syringes and medical equipments etc. can minimize hepatitis B & C infection. [ABSTRACT FROM AUTHOR]

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Background. Approximately 180 million persons (~2.8%) globally are estimated to be infected by hepatitis C virus (HCV). HCV prevalence in Mexico has been estimated to be between 1.2 and 1.4%. The aim of present work was to determine the prevalence of HCV infection in patients and family members attending two primary care clinics in Puebla, Mexico. Material and methods. Patients and their accompanying family members in two clinics were invited to participate in this study between May and September 2010. Results. A total of 10,214 persons were included in the study; 120 (1.17%) persons were anti-HCV reactive. Of the reactive subjects, detection of viral RNA was determined in 114 subjects and 36 were positive (31%). The more frequent risk factors were having a family history of cirrhosis (33.1%) and having a blood transfusion prior to 1995 (29%). After a multiple logistic regression analysis only transfusion prior to 1995 resulted significant to HCV transmission (p = 0.004). The overall detected HCV genotypes were as follows: 1a (29%), 1b (48.5%), 2/2b (12.8%), and 3a (6.5%). Conclusion. The HCV prevalence in this population is in agreement with previous studies in other regions of Mexico. [ABSTRACT FROM AUTHOR]

Acute hepatitis C virus ( HCV) infection is primarily followed by chronic infection, while spontaneous recovery of HCV infection ( SR- HCV) occurs in a minority of those infected. Identification of SR- HCV clinically depends on two combined indicators, persistently undetectable peripheral HCV RNA and positivity for anti- HCV. However, the characteristics of dynamic variation in anti- HCV antibodies in SR- HCV, especially in those patients co-infected with HIV, are still undefined. In this study, a cohort of patients infected with HCV through commercial blood collection practices was studied. We found that the annual decreasing rate of anti- HCV presented a gradually accelerated process in HCV resolvers. However, the variation in the decline of anti- HCV presented a slowly accelerated process within the early decrease stage and a gradually decelerated process within the latter decrease stage. In addition, we deduced that it expended approximately 16 years from natural HCV recovery to undetectable peripheral anti- HCV in HCV resolvers co-infected with HIV, while this time was estimated to be 20 years in SR- HCV without HIV co-infection. Our data indicated that the decay of anti- HCV was accelerated by HIV-related impairment of immune function. The prevalence of HCV infection may be severely underestimated in this large-scale retrospective epidemiologic investigation in an HIV-infected population. [ABSTRACT FROM AUTHOR]

Background. Patients exposed to hepatitis C virus (HCV) may develop chronic infection with viremia. The diagnosis of this condition requires the use of several laboratory tests in algorithms tailored to the population and resources available for each laboratory. Aim. We compared the diagnostic efficacy of two diagnostic algorithms for the identification of viremic patients with HCV. One based on confirmation of reactive antibody results with molecular techniques (reverse transcription polymerase chain reaction, RT-PCR) and the other based on the use of a new HCV core antigen test (HCV Ag). Material and methods. We measured levels of anti-HCV, HCV Ag and viral load (trough RT-PCR) in parallel, in 211 samples (53 antibody positive, 158 antibody negative). Using the three results available for each sample we simulated the diagnostic performance of the two algorithms and compared them to the results of RT-PCR as gold standard. Results. Both algorithms showed a high degree of concordance for viremic patients. The percentage of correctly classified patients was 99.05% for the algorithm based on RT-PCR and 98.10% for the HCV Ag algorithm. The HCV core Ag test showed a clinical sensitivity of 0.917 and showed a good correlation to the results of molecular biology. Spearman rank correlation coefficient (ρ) of 0.97 (95% CI 0.95 to 0.99, p < 0.0001). Conclusion. An algorithm incorporating HCV Ag as confirmatory test for anti-HCV results is a feasible alternative to the use of molecular techniques in laboratories that do not have access to them or require faster turn around times. [ABSTRACT FROM AUTHOR]

Background: Multiple transfusions in patients of thalassemia who are conventionally treated by a regular transfusion regimen. Though regular blood transfusion improves the overall survival of patients with thalassemia, it carries a definite risk of infection with blood-borne viruses. The present study was carried out to estimate the real frequency of hepatitis C virus (HCV) among Pakistani thalassemic patients, and determine the infection-associated risk factors in these patients. Objective: To determine the frequency of anti-HCV in children with multiple transfusions. Setting: Shalimar Hospital, Lahore. The samples were collected from Children Hospital, Mayo Hospital and Fatimid Foundation; Lahore. Period: June 2012 to Nov 2012. Subjects & Methods: One hundred blood samples were collected from the children with multiple transfusions. Two to three ml of blood was taken from each multiply transfused child who had received more than two blood transfusions. Serum was separated from each sample by centrifugation at 6000 rpm for 5 minutes. After serum separation, all the samples were stored at -80°C. The HCV antibody can be detected by anti-HCV Rapid Test but third or fourth generation enzyme linked immunosorbent assay (ELISA) is considered a better indicator of the seropositivity of this antibody. Results: The ages ranged from 6 months to >12 years. The mean age of children in the study was 6.17±4.13 years. There were 70 were males and 30 were females. Male to female ratio is 2.3:1. There are 58 thalassemic children, 27 different types of leukemia and 11 are aplastic anemia. Two children are with neuroblastoma while one each with thrombobasthenia and CDA-1. Conclusions: We concluded that a very high HCV prevalence which calls for adoption of stricter donor selection criteria, rigid implementation of quality control measures and use of more sensitive and specific techniques for HCV testing. [ABSTRACT FROM AUTHOR]

Background To investigate the correlation between anti-hepatitis C virus ( HCV) antibodies in saliva and detection of HCV RNA in saliva and salivary glands of patients with chronic hepatitis C. Methods A total of 180 samples of saliva (131 non-stimulated and 49 stimulated) from 133 patients with chronic hepatitis C were tested by ELISA for presence of anti- HCV antibodies. Results were compared with the detection of HCV RNA in saliva and salivary glands samples. Pearson's chi-squared and Fisher's exact tests were performed for statistical analysis. Results Anti- HCV antibodies could be detected in 47/180 (26.1%) saliva samples. In 11/47 (23.5%) of these, HCV RNA was also detected. From the 133/180 (73.9%) saliva samples with undetectable anti- HCV antibodies, 49/133 (36.8%) were positive for HCV RNA at least in one saliva sample. From the 64 patients from whom salivary gland samples were available, 17/64 (26.6%) had detectable anti- HCV antibodies in saliva, from which 2/17 (11.8%) also had HCV RNA in the salivary gland. From the 47/64 (73.4%) cases negative for anti- HCV antibodies in saliva, 10/47 (21.3%) were positive for HCV RNA in salivary gland. Conclusions Taken together, our results suggest that there is no correlation between the presence of anti- HCV antibodies in saliva and the detection of HCV RNA in saliva and salivary glands in patients with chronic hepatitis C. Nevertheless, as there was a statistically significant difference between detection of anti- HCV antibodies and HCV RNA in stimulated saliva, our study points toward the need for new research on mechanisms of HCV shedding in saliva. [ABSTRACT FROM AUTHOR]

Hepatitis C virus is a major public health problem and a causative agent of chronic liver disease worldwide. Hepatitis C virus infection is indolent and asymptomatic disease in human that can lead to liver cirrhosis and hepatocellular carcinoma. A cross sectional study was conducted in six selected districts of Balochistan. Blood samples of 1800 subjects (both genders aged between 18-60) were collected and sera/plasma were screened for anti-hepatitis-C virus (HCV) antibodies by rapid immunochromatography test (ICT). Out of 1800 subjects 1259 (70.0%) male and 541 (30.0%) female were screened for anti- HCV antibodies. A total of 161 (8.9%) subjects were found positive for anti-HCV antibodies. Gender and area were not found statistically associated (p>0.05) with the prevalence of anti-HCV antibodies. However, age group 41-50 years was found most susceptale to HCV. Keeping in veiw the alarming level of anti-HCV antibodies, routine screening of subjects through rapid ICT is suggested, which is an important and economical tool and can help in reduction of HCV transmission. [ABSTRACT FROM AUTHOR]

Abstract: Many anti-HCV antibodies are available, but more are needed for research and clinical applications. This study examines whether ascitic fluid from cirrhotic patients could be a source of reagent-grade antibodies. Ascitic fluid from 29 HCV patients was screened by ELISA for anti-HCV antibodies against three viral proteins: core, NS4B, and NS5A. Significant patient-to-patient variability in anti-HCV antibody titers was observed. Total ascitic fluid IgG purified by Protein-A chromatography reacted with HCV proteins in immunoblots, cell extracts, and replicon-expressing cells. Affinity-purification using synthetic peptides as bait allowed the preparation of cross-genotypic antibodies directed against pre-selected regions of HCV core, NS4B, and NS5A proteins. The performance of the polyclonal antibodies was comparable to that of monoclonal antibodies. Anti-NS4B antibody preparations reacted with genotype 1a, 1b, and 2a NS4B proteins in immunoblots and allowed NS4B to be localized in replicon-expressing cells. Ascitic fluid is an abundant source of human polyclonal cross-genotypic antibodies that can be used as an alternative to blood. This study shows the utility of selectively purifying human polyclonal antibodies from ascitic fluid. Affinity purification allows antibodies to be selected that are comparable to monoclonal antibodies in their ability to react with targeted regions of viral proteins. [ABSTRACT FROM AUTHOR]

To assess the impact of the French national hepatitis C prevention programme initiated in 1999, we analysed trends in hepatitis C virus (HCV) prevalence, testing and characteristics of HCV-infected patient at first referral from 1994 to 2006. We used four data sources: Two national population-based sero-prevalence surveys carried out in 1994 and 2004; two surveillance networks, one based on public and private laboratories throughout France and the other on hepatology reference centres, which aim to monitor, respectively, trends of anti-HCV screening and of epidemiological–clinical characteristics of HCV patients at first referral.Between 1994 and 2004, the anti-HCV prevalence for adults aged 20–59 years decreased from 1.05 (95% confidence interval 0.75–1.34) to 0.71 (0.52–0.97). During the same period, those anti-HCV positive with detectable HCV RNA decreased from 81 to 57%, whereas, the proportion of anti-HCV positive persons aware of their status evolved from 24 to 56%. Anti-HCV screening activity increased by 45% from 2000 to 2005, but decreased in 2006 (−10%), while HCV positivity among those tested decreased from 4.3 to 2.9%. The proportion of cirrhosis at first referral remains around 10% between 2001 and 2006, with many patients with excessive alcohol consumption (34.7% among males) or viral co-infections (HIV seropositivity for 5.2% patients). Our analysis indicates that the national programme had a positive impact at the population level through improved prevention, screening and management. There is still a need to identify timely those at risk for earlier interventions, to assess co-morbidities better and for a multidisciplinary approach to HCV management. [ABSTRACT FROM AUTHOR]

The prevalence of anti-HCV antibodies among patients on dialysis is consistently higher than in healthy populations, suggesting that dialysis patients may be at higher risk of acquiring HCV infection. The aim of our study was to determinate the prevalence of anti-HCV antibodies in patients whom attend to dialysis facilities in Cali, Colombia. 999 patients were tested using the third generation enzyme linked immunosorbent assay (ELISA-3), 29 patients were Anti-HCV positive (2,9% prevalence). All Anti-HCV positive patients were tested to detect the HCV- RNA using a real time-PCR qualitative test (Amplicor Monitor 2.0 Roche Molecular Systems), 26/29 patients were HCV-RNA positive (89%). Conclusions: The prevalence of anti-HCV antibodies in the dialysis facilities in Cali (2.9%) is very similar to the prevalence reported by industrialized countries. [ABSTRACT FROM AUTHOR]

The prevalence of anti-HCV antibodies among patients on dialysis is consistently higher than in healthy populations, suggesting that dialysis patients may be at higher risk of acquiring HCV infection. The aim of our study was to determinate the prevalence of anti-HCV antibodies in patients whom attend to dialysis facilities in Cali, Colombia. 999 patients were tested using the third generation enzyme linked immunosorbent assay (ELISA-3), 29 patients were Anti-HCV positive (2,9% prevalence). All Anti-HCV positive patients were tested to detect the HCV- RNA using a real time-PCR qualitative test (Amplicor Monitor 2.0 Roche Molecular Systems), 26/29 patients were HCV-RNA positive (89%). Conclusions: The prevalence of anti-HCV antibodies in the dialysis facilities in Cali (2.9%) is very similar to the prevalence reported by industrialized countries. [ABSTRACT FROM AUTHOR]

Rapid diagnostic tests ( RDTs) represent an attractive alternative to enzyme immunoassays. A total of 207 individuals, including 68 HCV-seronegative subjects, 10 patients with resolved infection and 129 patients with chronic HCV infection, were studied. The specificity of RDT detection of anti- HCV antibodies in whole blood was 100% with the four RDTs tested: OraQuick® HCV Rapid Antibody Test, First Response HCV Card Test, ASSURE HCV Rapid Test and MultiSure HCV Antibody Assay. Their diagnostic sensitivity varied between 98.6% and 100%. RDT detection of anti- HCV antibody in whole blood collected on dried blood spots appears to be a promising new tool for broadscale screening of HCV infection in high- to medium-risk populations. [ABSTRACT FROM AUTHOR]

Background: Haemodialysis (HD) patients are at an increased risk of Hepatitis C virus (HCV) infection, which is significantly associated with increased morbidity and mortality. Aim: The aim of this study was to find the prevalence of HCV infection in anti-HCV antibody negative haemodialysis patients by Real-time PCR (RT-PCR) and value of HCV-RNA among seronegative patients undergoing haemodialysis in a remotely located tertiary care hospital. Materials and Methods: A total of 100 chronic renal failure patients on haemodialysis were studied. All the patients were screened for anti-HCV antibodies by ELISA test and for HCVRNA by RT-PCR. Results: The overall prevalence of HCV infection was 32%. Antibody positivity was 30% and HCV-RNA by RT-PCR was detected in 20%. HCV-RNA in seronegative patients was detected in 2.8%. Conclusion: Serological assays (30%) are quite reliable for detecting HCV infection in patients undergoing haemodialysis in our tertiary care hospital. Only a small proportion of them (2.8%) require the documentation of viral genome for current infection. [ABSTRACT FROM AUTHOR]

We studied the epidemiological, laboratory and histological characteristics of a group of patients with positive antibodies against hepatitis C virus (HCV) as determined by third-generation enzyme-linked immunosorbent assay (ELISA), and with indeterminate HCV antibody positivity as established by third-generation recombinant immunoblot assay (RIBA-3). The results obtained were compared with those recorded in a group of RIBA-3-positive patients. Both groups correspond to blood donors in whom the prevalence of hepatitis C is low. There were no statistically significant intergroup differences in mean age, or in the presence of infection risk factors. RNA positivity was much more frequent in the RIBA-positive group (71% vs 10%; P < 0.05), as was transaminase elevation during the 3 years of follow-up (54% vs 13%; P < 0.05). In 46% of the RIBA-indeterminate patients the liver biopsy proved normal, or only liver steatosis or minimal changes were detected, while 33% had persistent chronic hepatitis, and 21% showed active chronic hepatitis. A mean Knodell index score of 2.28 was recorded; 50% of the subjects showed no fibrosis, 46% grade 1 fibrosis (fibrous portal expansion), 4% grade 2 fibrosis (bridging fibrosis), and none grade 3 fibrosis (liver cirrhosis). In the RIBA-positive group, a greater percentage of patients had active chronic hepatitis, a greater Knodell index, and increased-grade fibrosis. It can be concluded that the RIBA-3-indeterminate group is epidemiologically similar to the RIBA-3-positive series, although with a lesser prevalence of laboratory test alterations, a lower viral replication index, and more likely to have benign disease – particularly in subjects without viral replication. [ABSTRACT FROM AUTHOR]

Abstract: Background:: Most studies evaluating antibody detection assays are conducted on samples from healthy blood donors but not on samples of hospitalized patients which can show non-specific reactions. Objectives:: To compare the performance of three commercial automated assays for the detection of hepatitis C virus (HCV) antibodies, Monolisa anti-HCV Plus version 2, Axsym anti-HCV 3.0 and Vitros anti-HCV, on a population of hospitalized patients. Study design:: The specificity of the assays was prospectively evaluated in 2020 routine serum samples. In order to assign the serostatus of each sample, those giving positive or discordant results were further tested by three immunoblots and by RT-PCR (Roche). Moreover, the sensitivity was evaluated on eight commercial HCV seroconversion panels. Results:: The Monolisa, Axsym and Vitros assays showed specificities of 99.64%, 99.12% and 99.33%, respectively. Concerning the sensitivity, among 49 samples, the number of positive results was 21, 24 and 24 for the Monolisa, Axsym and Vitros kits, respectively. The differences were not statistically significant at an alpha risk of 5%. Conclusions:: All assays appeared to be reliable for routine screening, but there were a surprising number of indeterminate samples that could not be resolved by confirmatory tests. [Copyright &y& Elsevier]

Vital Hepatitis due to Hepatitis Β Virus (HBV) and Hepatitis C virus (HCV) are important causes of cirrhosis and HCC which results in increased morbidity and mortality. In this retrospective study, total 3071 patients were enrolled, out of which 2198 & 873 patients were asked for detection HBsAg alone and anti HCV Ab Plus HBs Ag respectively. Out of total 3071 patients, 43 patients (1.43%) showed HBsAg positively, whereas none of the patients (0%) showed dual infection with HCV.

The prevalence of HCV antibodies was determined by a second-generation FLISA and a four-antigen recombinant immunoblot assay in nine intravenous immunoglobulin (IVIG) preparations commercially available in Italy. In addition, the clinical safety of six of them was ascertained by polymerase chain reaction (PCR) of HCV RNA and a prospective study in 14 patients with immunodeficiency disorders. Results indicated that all IVIG preparations were anti-HCV-positive. However, there were substantial variations in their anti-HCV antibody titres. The preparations retained IgG subclass reactivities to HCV-associated structural (C22-3) and non-structural (C33c, C100-3) proteins. Our sensitive and specific PCR assay was unable to detect HCV RNA in the six preparations tested. Clinical surveillance of IVIG-treated patients prospectively evaluated over a mean period of 8 3 months failed to detect clinical and/or biochemical evidence of hepatitis. [ABSTRACT FROM AUTHOR]

A prospective study was begun in our haemodialysis unit after four previously negative patients were found to be anti-HCV positive. A dedicated area and dedicated dialysis equipment (but not a separate room) were assigned to anti-HCV-positive patients and testing for HCV antibodies was performed every 3 months. A total of 131 patients were treated during the study period of 18 months. Of these, 50 patients were dialysed during the entire 18 months, and 21 were available to be tested six or more months after having left the centre. During the first 6 weeks after implementing the precautions two more anti-HCV-positive patients were detected. However, during the rest of the study period no further newly infected patients were found. It is concluded that the spread of HCV infection in a haemodialysis environment can be prevented by limited isolation procedures. [ABSTRACT FROM PUBLISHER]

We conducted a prospective study in HD patients of our unit to evaluate the incidence of seroconversion for HCV in this high-risk group. Two hundred and thirty-five patients were observed during the average follow-up of 29.4 months: 183 were seronegative and 52 seropositive for anti-HCV antibodies at the start of the study. During the observation period two of 183 patients developed anti-HCV antibodies late in the study, while the other 181 patients remained seronegative throughout the observation period; anti-HCV antibodies persisted through the follow-up in the 52 HCV-positive patients at the beginning of the study. Our results showed a very low incidence of HCV seropositivity (0.44% per year) after implementation of our operative protocol including ‘universal precautions’ and other infection control procedures. Once infected, there is no disappearance rate of anti-HCV. The 4-RIBA results did not change during the follow-up period. Prevalence of HCV RNA by PCR technique was 41% (22 of 54) among anti-HCV-positive patients. Future investigations are warranted to clarify the exact route of transmission of HCV among HD patients and to reduce the rate of HCV transmission in this clinical setting. [ABSTRACT FROM PUBLISHER]

There are no data regarding HCV prevalence in CRF patients not requiring dialysis. In order to assess prevalence and risk factors for HCV infection in CRF patients on conservative therapy we tested, by second-generation assays such as Ortho 2 and 4-RIBA, 221 predialysis CRF patients attending our Department. Forty-four (20%) patients were anti-HCV positive. Anti-HCV positivity was related to blood transfusion requirement, past or current elevations of transaminase levels and, to a lesser degree, CRF duration. The prevalence of anti-HCV positivity among CRF patients who were never transfused was about 10 times higher than that of blood donors. Our data show that predialysis CRF patients should be considered a specific risk group for HCV infection; blood transfusion history and duration of CRF are risk factors for acquisition of HCV infection; HCV infec tion may play a role in the development of liver disease in this clinical setting. [ABSTRACT FROM PUBLISHER]

Non-A Non-B hepatitis (NANBH) is nowadays one of the most common causes of hepatic dysfunction in dialysis patients. We reviewed the records of 231 HBsAg-negative patients in our unit and found 119 patients with biochemical criteria of NANBH (51.5%), 88 of them (68.9%) with circulating antibodies against HCV ( <0.0001). Such high prevalence of NANBH was due to an outbreak of NANBH in the late 70s and early 80s. Time on haemodialysis (HD) was the major risk factor of NANBH in this population, and no other risk factors were identified. Prevalence of anti-HCV was similar to reports from non-uraemic populations.Anti-HCV seems to be a reliable test to confirm NANBH, but not better than using common bio-chemical criteria of NANBH to manage these patients in dialysis units. [ABSTRACT FROM PUBLISHER]

The diagnostics of community-acquired acute HCV hepatitis in an endemic area was studied in 110 Egyptian patients with acute jaundice. In the first week of the jaundiced period 30 of 110 patients (27.3%) had anti-HCV antibodies. The majority already showed high levels of anti-HCV IgG (25/30), associated with anti-HCV IgM in nine of them. Five patients showed only an HCV IgM reactivity. Seven had also anti-HEV and/or anti-HBV: their jaundice could then be related to an acute infection caused by those viruses. All patients were infected with genotype 4a, in three associated with the 3a. During the follow-up five patients seroconverted for IgG, while their anti-HCV IgM did not show a uniform pattern of reactivity. Patients with positive serology suspected of an acute HCV infection were older than the patients with other acute hepatitis and showed a lower peak of ALT level. Seroconversion during acute hepatitis strongly indicated HCV as the etiologic agent. However, the detection of anti-HCV IgG antibodies in the jaundiced period showed that the majority of patients had already seroconverted to anti-HCV antibodies; in most of them it is possible to hypothesize a reactivation of a chronic HCV infection. [ABSTRACT FROM AUTHOR]

No data are available for the kinetics of anti-Hepatitis C Virus (HCV) antibodies in HIV/HCV co-infected patients after sustained virological response (SVR). We present a case of a HIV/HCV co-infected patient, showing a significant anti-HCV antibodies decrease during therapy, who achieved a HCV seroreversion 3 years after SVR. Among them, antibodies to core protein, the most strongly antigenic protein showed significant decrease. Our results indicate an absence of antigenic stimulation suggesting a total clearance of HCV. [ABSTRACT FROM AUTHOR]