Anti Hepatitis C Virus Research Articles

Antiviral Activity of Indonesian Plants from East Java Region Againts Hepatitis C Virus

Hepatitis C virus (HCV) is a major cause of liver disease worldwide and a potential cause of substantial morbidity and mortality in the future. The most recent WHO estimate of the prevalence of HCV infection is 2%, representing 120 million people. Current standard of care is effective in only 50% of the patients, poorly tolerated, and associated with significant side effects and viral resistance. Therefore, a new drugs is needed for the development of complementary and alternative treatment strategies for HCV infection. A variety of medicinal plants have demonstrated antiviral efficacies and some of them possess broad spectrum antiviral activities. In this study, some of Indonesian medicinal plants were evaluated for their anti-HCV activities. Ethanol extracts of 21 samples derived from 19 species of plants that were explored from East Java Region were tested. Anti HCV activities were determined by cell culture method using Huh 7.5 cells and HCV J6/JFH1. The results showed that 6 of 21 samples have potential activity against HCV: Eucalyptus globulus stem (IC5 : 15.1 μg/ml), Toona sureni leaves (IC5 : 11 μg/ml), Melicope vitiflora leaves and stem (IC5 : 9.6 and 15.7 ug/ml, respectively), Melanolepis multiglandulosa stem (IC5 : 15.5 μg/ml) and Ficus fistulosa leaves (IC5 5 : 23.0 μg/ml). These plant extracts may be good candidates for the development of anti-HCV drugs.

Comparison of Association of Diabetes Mellitus in Hepatitis C Virus Infection and Hepatitis B Virus Infection

Abstract Background: While patients with liver disease are known to have a higher prevalence of glucose intolera-nce, preliminary studies suggest that hepatitis C virus (HCV) infection may be an additional risk factor for the development of diabetes mellitus (DM). Objective: The presented study was aimed to study and determine a relationship between the relative pro-portions of Diabetes Mellitus in patients suffering from HCV infection. Study Design: This cross sectional study. Study Settings: Patients were registered from outdoor as well as indoor departments of different teaching hospitals (Services hospital Lahore and medical depar- tments in Jinnah hospital, Mayo hospital, Sir Ganga Ram hospital) in Lahore, Pakistan. Methods: This cross sectional study was comprised of age and sex matched 258 patients of viral hepatitis B infection and viral hepatitis C infection, conducted at Hepatitis Clinic Services Hospital, affiliated with Post Graduate Medical Institute, Lahore. Diagnosis of HBV was made with evidence of hepatitis B surface antigen, HCV infection was diagnosed if patient was sero positive for anti HCV (ELISA methods) and HCV - RNA (By PCR). Diabetes Mellitus was diag-nosed after fulfilling the American Diabetic Associ-ation Criteria, from November, 2000 to September, 2002. Results: A total of 318 patients were registered, out of which 258 cases fulfilled the inclusion criteria, 164 hepatitis C infected and 94 hepatitis B infected cases, 16.46% hepatitis C infected cases were diagnosed as diabetics while 4.25% hepatitis B infected cases were diagnosed as diabetics. Conclusion: This study concludes that there is high Association and relationship of Diabetes Mellitus with Hepatitis C virus infection as compared with Hepatitis B virus infection. Key words: Hepatitis B, Hepatitis C, diabetes Melli-tus.

Transfusion transmittable infections - Seroprevalence among blood donors in a tertiary care hospital of Delhi

Context:Transfusion transmittable infections (TTI) continue to be a major threat to safe transfusion practices. Blood is one of the major sources of transmission of infectious diseases viz. human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis, malaria, and many other infections in India. Screening assays for the infectious diseases with excellent sensitivity and specificity helps to enhance the safety of the blood transfusions reducing the diagnostic window period as much as possible.Aims:The present study was designed to determine the seroprevalence of TTIs viz., HIV, HCV, and HBV, among the blood donors in Max Super Specialty Hospital, New Delhi, India based on dual testing strategy using high sensitive screening assays such as enhanced chemiluminescence assay and nucleic acid testing (NAT).Materials and Methods:A total of 41207 blood units collected from the donors (both voluntary and replacement donors) were screened for the TTI s, viz., anti HIV 1 and 2 antibody, anti HCV antibody, anti HBcore antibody, and HBsAg by enhanced chemiluminescence assay on VITROS® ECiQ immunodiagnostics system. NAT was performed using Roche Cobas® TaqScreen MPX assay, which can detect simultaneously HIV 1 (groups M and O), HIV-2, HCV, and HBV on Roche Cobas® s201 system.Results:The seroprevalence of HIV, HBsAg, anti HBcore antibody, and HCV based on enhanced chemiluminescence assay was found to be 0.25, 0.2, 7.06, and 0.7%, respectively. A total number of 6587 samples from July 2010 to December 2010 were tested on NAT, of which 3 samples were reactive for HBV in NAT; this was missed by enhanced chemiluminescence assay.Conclusions:Based on the seroprevalence study of infectious diseases viz., HIV, HBV, and HCV, we conclude that screening of blood and blood components by dual testing strategy using high sensitivity serological assay like enhanced chemiluminescence technology and NAT helps in detecting the potentially infectious blood units in all phases of infection, which aids in enhancing the safety of blood transfusion and reducing the potential risk of post-transfusion infection.

Red cell alloimmunization and infectious marker status (human immunodeficiency virus, hepatitis B virus and hepatitis C virus) in multiply transfused thalassemia patients of North India

Patients with thalassemia major are largely transfusion dependent and are thus exposed to a variety of risks such as transmission of infectious diseases, iron overload and alloimmunization. This study was performed to determine the prevalence of human immune deficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and red cell antibodies among multiple-transfused thalassemic patients in and around the national capital region. The Department of Transfusion Medicine, Indraprastha Apollo Hospitals, conducted this study in collaboration with the National Thalassemia Welfare Society over a period of 1 year starting February2011. Blood samples from the patients were tested for blood group, red cell alloantibody/ies, anti-HIV, anti-HCV and hepatitis B surface antigen (HBsAg) by ELISA and for the respective viral ribonucleic acid (RNA) or deoxyribonucleic acid (DNA) by nucleic acid testing (NAT). A total of 462 thalassemics which consists of 290 males and 172 females were tested. The overall alloimmunization rate was 4.1% and anti-Kell was the most common antibody identified. Thirteen cases (2.8%) were positive for HBsAg by ELISA, 107 (23.1%) were reactive for anti HCV and 11 (2.38%) for anti HIV antibodies. Further screening and discriminatory assays by NAT confirmed the presence of HBV DNA in 11 cases, HIV RNA in 7 cases and HCV RNA in 48 cases. In spite of advances in Immunohematology and infectious marker testing in recent years, the rates of alloimmunization and infectious marker positivity remains high among multiply transfused patients like thalassemics. Provision of safe and adequate blood supply to these patients is a key to improving their quality-of-life and longevity.

English

Hepatitis C virus (HCV) continues to be a major disease burden affecting about 200 million people in world. Using blood donors as a prevalence source may underestimate the real prevalence of the virus because the donors are highly selected population. Presently more evidences support intravenous drug use as leading risk factor for the spread of virus. OBJECTIVES: The study aims at finding out the seroprevelance of Hepatitis C virus in high risk individuals as well as healthy blood donors. SETTINGS AND DESIGN: The study group comprise of 350 subjects which included 150 healthy voluntary donors as control group and 200 subjects taken from different high risk population like intravenous drug abuser (50), patients on long term haemodialysis (40), patients with chronic liver disease (50), HIV positive cases (30), health care workers (30). STATISTICAL ANALYSIS USED: Percentage. RESULTS: Seropositivity for anti HCV antibody was found to be 12% (24/200) among high risk population and 0.66 % (1/150) in healthy voluntary blood donors. Among different high risk groups, maximum prevalence rate 28% (14/50) was found in I.V drug abusers. Fifty percent (7/14) of the seropositive parenteral drug abusers were male in the age group of 21-30 years followed by 35.7% (5/14) in 31-40 years of age group. Only one female (7.14%) between 21-30 years was found to be sero-reactive for antiHCV antibody. In HIV co-infected cases 13.33 % (4/30) were seropositive for antiHCV antibody. In chronic liver disease (two hepatocellular carcinoma, one cirrhosis and one chronic hepatitis) and long standing haemodialysis, the prevalence rate for anti HCV was found to be 8% (4/50) and 5% (2/40) respectively. None of the health workers (0/30) found to be sero-reactive for antiHCV antibody. CONCLUSIONS: HCV poses a serious worldwide health problem affecting people from all walks of life in every country. In the present study 12% and 0.66% HCV prevalence was noticed in high risk group and healthy blood donors respectively. Among high risk group maximum prevalence (58.33%) was found in IV drug abusers. Prevention should target the reduction of virus transmission by health education, risk reduction counseling and thorough HCV screening following the suggestion of CDC, Atlanta, USA.

Hepatitis C in the Kidney Transplant Recipients at Choray Hospital - South Vietnam

Background: Hepatitis C virus (HCV) infection is common cause of cirrhosis and hepatic cancer. HCV Contaminated incidence in Vietnam about 4-10%. 85% HCV infection cases become chronic infection. In RT patients, HCV is mainly cause of progressive liver diseases and death. So that, a research about evolution of hepatitis C in RT is necessary. Purposes: This study aimed to evaluate the epidemiologic, ratio, clinical and laboratory aspect of hepatitis C and also analyze the outcome of hepatitis C on the group of the kidney transplant recipients who are following at Cho Ray hospital- South Viet Nam. Subjects and methods: This is a case study was performed from January 1992 to December 2009 at Cho Ray hospital. All of kidney transplant recipients was tested SGOT,SGPT and anti HCV at the first admission to looking for hepatitis C. if anti HCV positive, next step was perform HCV DNA to definitive diagnosis hepatitis C (only from 1993 to now). All of kidney transplant recipients with hepatitis C will be follow up on hepatic functions every month, abdominal echography, fibroscan every year and PCR was performed every year on hepatitis C and anytime necessary. Diagnostic criteria: HCV RNA (+) and/or anti HCV (+) Analysis soft wear: by Epi-info softwear -Version 2007 It included 22 hepatitis C in 433 kidney transplant recipients. Results: 1. The rate of hepatitis C was 5.08% (22/433 kidney transplant recipients). It includes 16 pts hepatitis C infection alone and 6 pts coinfection with HBV and HAV. Male is 81.8% and average age is 49yrs. Means follow up time is 6.4yrs (1 to 18yrs) 2. 8 cases were performing kidney transplantation at Viet Nam and 100% of them received kidney from their relative. 14 cases was perform kidney transplantation at other country and ratio of them received kidney from their relative only was 7.14%. Further more, patient has hepatitis C before take RT was 50%, and 81. 8% of them from other countries. 3. Increased transaminase levels was observed in 40.9% RT pts HCV infection 4. Serum diagnosis test: Anti HCV (+) and HCV RNA (+): 20/22 (90%) Anti HCV (-) and HCV RNA (+): 2/22 (10%) 5. Fibro scan test: 17 patients with hepatitis C were evaluated by fibro scan: F0: 2cases (11. 7%) F1: 9cases (52.9%) F2: 3cases (17.6%) F3: 3cases (17.6%) 6. Accompany diseases consist of diabetes and hypertension was presented in 36.3% and 100% of patients respectively. 7. Immune depressions regiment: CsA+Prednisone+Azathioprine 3 cases (13.6%) CsA+prednisone+MMF 14cases (63.6%) FK506+MMF+Prednisone 5cases (22.7%) 8. Specific treatment: One case hep.C was treated interferon before RT and follow up in 3 years after with SRV (sustain virus response) Conclusion: Hepatitis C was 5.08% in RT group at Choray hospital- VN. (It was 2% in USA and was 9% in India). Increased transaminase levels were observed in 40.9%. Patient have hep.C before take RT was 50%, and 81,8% of them from other country. Common accompany diseases consist of diabetes and hypertension.

Awareness and Treatment Adherence of Patients With Chronic Hepatitis C Infection: A Survey at an Inner City Teaching Hospital

Purpose: In the United States, approximately 4 million persons are infected with Hepatitis C virus (HCV), and 8,000 to 10,000 people die of HCV-related liver disease annually. The cost of treatment can be substantial with the new drugs Boceprevir and Telaprevir costing $1,100 and $4,100 per week, respectively. Metrohealth Medical Center is a major health organization in Cleveland, Ohio providing care to hepatitis C patients in the liver clinic managed by fellows and attendings. It has been our observation that patients' knowledge about the disease in question varied and adherence to treatment amongst a few patients has been less than adequate. In order to try and understand the scope of this problem, we undertook a patient survey to determine the disease awareness and treatment adherence of patients with chronic hepatitis C infection on or eligible to start treatment. To the best of our knowledge, this is the first study which looked at disease awareness and treatment adherence while on anti HCV treatment. Methods: A brief questionnaire consisting of 24 items was given to recruited patients with chronic hepatitis C infection on or being considered for anti viral treatment. Results: A total of 46 patients with Hepatitis C Virus Infection (HCVI) on or being considered for treatment chose to respond to the survey. African American and Hispanic patients constituted 40% of the respondents which represents the patient demography being served by the hospital. 54% of the respondents had graduated from high school. 14% respondents were unable to correctly identify the anti-viral drugs with which they were being treated for HCVI. Nearly 14% of the respondents could not recall the approximate date when they were started on treatment. 18% of the patients on HCV treatment could not answer correctly the proposed duration of the entire course of therapy. Only 41.3% of the respondents were able to list out at least 3 side effects to watch for while on HCV treatment. A significant minority (8.5%) reported non adherence to HCV treatment. 24% of the respondents on HCV treatment did not have an understanding about the importance of being treated. 15% of the respondents reported that they were not diligent in making regular follow-ups while being on treatment. 51.1% of the respondents were not aware of contraceptive requirement while on treatment. Conclusion: Nearly 50% of the respondents were not aware that contraceptive use was mandatory while on treatment. Since recruitment was done at several stages during initiation of treatment, this could explain the poor response to the question of contraceptive use. We will use this finding to reinforce this aspect during pre-treatment counseling.Table: Awareness and understanding of treatment

Risk management for biological agents I in rheumatoid arthritis

BackgroundTNF antagonists have been successfully used for the treatment of rheumatoid arthritis (RA). However, data from clinical trials and databases have shown that patients treated with these biological agents have...

DETECTION OF CIRCULATING HEPATITIS C VIRUS NON-STRUCTURAL PROTEIN IN CHRONIC HEPATITIS C VIRUS AND IN HAEMODIALYSIS PATIENTS

­Infection with hepatitis C virus (HCV) is a major cause of chronic liver disease. On the other hand, Nosocomial transmission of HCV is a concern in haemodialysis (HD) units worldwide. In these patients, blood transfusions and long term dialysis are risk factors for transmission of HCV. Diagnosis of HCV infection is currently based on the detection of anti HCV antibodies by ELISA, and is confirmed by HCV RNA. The aim of the present study was to identify and detect the circulating non structural protein by using ELISA ,SDS-PAGE and Western blot techniques and to evaluate the usefulness of the detection of HCV antigen using ELISA for therapeutic follow-up (at 0 times, 12, 24 and 48 weeks) in selected 10 positive HCV-RNA patients at 0 times . Serum samples of 75 chronic hepatitis C (CHC) patients, serum samples of 75 haemodialysis patients and 25 healthy individual's sera as a negative control were included in this study. HCV antigen was detected in these samples using ELISA and Western blotting techniques. Western blot analysis showing a single immune reactive band in serum of CHC and haemodialysis patients infected with HCV at 27-KDa. ELISA technique was applied to detect the 27-KDa antigen. The cutoff level of ELISA above or below which the tested sera were considered positive or negative was calculated and was found to be 0.28 Based on this cut off the HCV antigen was detected in 80 % of CHC patients and in 36 % of haemodialysis patients. While, it was found that all healthy individuals used as a control were 100 % negative for HCV antigen. Furthermore, detection of HCV-RNA using nested PCR and HCV-NS4 antigen using ELISA for pre-therapeutic and therapeutic (combined interferon (IFN) and ribavirin therapy) at 0 time, 12, 24 and 48 weeks in 10 HCV-infected persons undergoing treatment was studied. The detection of HCV-NS4 antigen for these 10 positive HCV-RNA samples at (12 weeks and 24 weeks) showed that (60 %) were responsive for treatment and it was found that (40 %) did not respond.

Removal of Hepatitis C Virus-Infected Cells by a Zymogenized Bacterial Toxin

Hepatitis C virus (HCV) infection is a major cause of chronic liver disease and has become a global health threat. No HCV vaccine is currently available and treatment with antiviral therapy is associated with adverse side effects. Moreover, there is no preventive therapy for recurrent hepatitis C post liver transplantation. The NS3 serine protease is necessary for HCV replication and represents a prime target for developing anti HCV therapies. Recently we described a therapeutic approach for eradication of HCV infected cells that is based on protein delivery of two NS3 protease-activatable recombinant toxins we named “zymoxins”. These toxins were inactivated by fusion to rationally designed inhibitory peptides via NS3-cleavable linkers. Once delivered to cells where NS3 protease is present, the inhibitory peptide is removed resulting in re-activation of cytotoxic activity. The zymoxins we described suffered from two limitations: they required high levels of protease for activation and had basal activities in the un-activated form that resulted in a narrow potential therapeutic window. Here, we present a solution that overcame the major limitations of the “first generation zymoxins” by converting MazF ribonuclease, the toxic component of the E. coli chromosomal MazEF toxin-antitoxin system, into an NS3-activated zymoxin that is introduced to cells by means of gene delivery. We constructed an expression cassette that encodes for a single polypeptide that incorporates both the toxin and a fragment of its potent natural antidote, MazE, linked via an NS3-cleavable linker. While covalently paired to its inhibitor, the ribonuclease is well tolerated when expressed in naïve, healthy cells. In contrast, activating proteolysis that is induced by even low levels of NS3, results in an eradication of NS3 expressing model cells and HCV infected cells. Zymoxins may thus become a valuable tool in eradicating cells infected by intracellular pathogens that express intracellular proteases.

Prevalence of hepatitis C virus (HCV) in Gadap Town Karachi, Pakistan.

Hepatitis C has been increasing day by day due to unsafe and unsterilized use of injections and razor in rural areas. The present study was conducted to determine the frequency of Hepatitis C and Hepatitis B in Gadap Town Karachi, Pakistan. 600 hundred subjects were enrolled. 47% were females and 53% were males. Mean ages of females was 25 years and mean age of male was 24 years. In Gadap Town, 5% was anti HCV reactive. Risk factor for transmission of Hepatitis C virus (HCV) was unsterilized syringes and razor use in this area.

Rising burden of Hepatitis C Virus in hemodialysis patients

AimHigh prevalence of Hepatitis C virus (HCV) has been reported among the dialysis patients throughout the world. No serious efforts were taken to investigate HCV in patients undergoing hemodialysis (HD) treatment who are at great increased risk to HCV. HCV genotypes are important in the study of epidemiology, pathogenesis and reaction to antiviral therapy. This study was performed to investigate the prevalence of active HCV infection, HCV genotypes and to assess risk factors associated with HCV genotype infection in HD patients of Khyber Pakhtunkhwa as well as comparing this prevalence data with past studies in Pakistan.MethodsPolymerase chain reaction was performed for HCV RNA detection and genotyping in 384 HD patients. The data obtained was compared with available past studies from Pakistan.ResultsAnti HCV antibodies were observed in 112 (29.2%), of whom 90 (80.4%) were HCV RNA positive. In rest of the anti HCV negative patients, HCV RNA was detected in 16 (5.9%) patients. The dominant HCV genotypes in HCV infected HD patients were found to be 3a (n = 36), 3b (n = 20), 1a (n = 16), 2a (n = 10), 2b (n = 2), 1b (n = 4), 4a (n = 2), untypeable (n = 10) and mixed (n = 12) genotype.ConclusionThis study suggesting that i) the prevalence of HCV does not differentiate between past and present infection and continued to be elevated ii) HD patients may be a risk for HCV due to the involvement of multiple routes of infections especially poor blood screening of transfused blood and low standard of dialysis procedures in Pakistan and iii) need to apply infection control practice.

Lichen planus and Hepatitis C: A case-control study

Background The exact cause of LP is not known. However, the associationof lichen planus with hepatitis C virus (HCV) infection has been reported inliterature. A wide variation in the reported prevalence of HCV infection inpatients with lichen planus in different geographical areas was observed. This case – control study was conducted to determine the frequency of hepatitis C in Sudanese patients with lichen planus at Khartoum Dermatology teaching hospital, Khartoum, Sudan.Methods During the year2010, 44 cases of lichen planus, 29 (62.5%) women and 15 (37.5%) men were diagnosed. They were diagnosed on the basis of the usual clinical features and, if necessary, typical histological findings. The patients were screened for the presence of anti-HCV antibodies by third generation ELISA and liver function tests. We used the results from screening of blood donors for anti HCV (carried out by Khartoum Hospital Blood Transfusion Bank) for comparison as the control group.Results None of the 44 patients with lichen planus, and the control group, had anti-HCV antibodies by ELISA-2.Conclusion It is likely that HCV virus have no an etiologic role in lichen planus in Sudanese patients.

Adiponectin and interlukin-10 in patients with liver diseases before and after liver transplantation

Background/Aims: Hepatitis C virus (HCV) infection is a global blood-borne disease with the highest prevalence in Egypt. This study was carried out to evaluate the prevalence of adiponectin, Interleukin-10 levels in liver diseases and to identify the potential role of adipocyte derived adiponectin in patients with end stage before and after liver transplantation. Subject & method: The study population included 69 subjects classified as follow: Control group (G1) healthy individuals, group (G2) Anti HCV +ve & HCV RNA +ve by PCR, group (G3) Anti-HCV +ve H before liver transplantation (G4b) and after one week of liver transplantation (G4a). Result: Adiponectin levels showed highly significant decrease in G2 (P <0.002), G3 showed insignificant decrease (P<0.6), G4b showed highly significant increased (P <0.0001) and G4a showed insignificant decrease (P<0.08) compared with control group G1. IL-10 levels showed highly significant increase in patients groups (G2, G3, G4b and G4a) as compared with control group (P<0.0001). Conclusion: Adiponectin and IL-10 may be used as biomarker and/or a mediator of inflammatory states in liver diseases in patients with chronic hepatitis C. We suggest that high adiponectin and IL-10 levels in chronic liver disease before liver transplantation might reflect one of the body’s anti-inflammatory mechanisms in chronic liver diseases.

Serial follow-up of repeat voluntary blood donors reactive for anti-HCV ELISA.

Background:Voluntary non-remunerated repeat blood donors are perceived to be safer than the first time blood donors. This study was planned for follow-up of previous hepatitis C virus (HCV) test results of anti-HCV enzyme-linked immunosorbent assay (ELISA) reactive repeat blood donors. The aim was to suggest a protocol for re-entry of the blood donors who are confirmed HCV negative by nucleic acid test (NAT) and recombinant immunoblot assay (RIBA). A group of repeat voluntary donors were followed retrospectively who became reactive on a cross sectional study and showed HCV reactivity while donating blood regularly.Material and Methods:A total of 51,023 voluntary non remunerated blood donors were screened for anti-HCV ELISA routinely. If anybody showed positivity, they were tested by two ELISA kits (screening and confirmatory) and then confirmed infection status by NAT and or RIBA. The previous HCV test results of repeat donors reactive by anti-HCV ELISA were looked back from the records. Data of donors who were repeat reactive with single ELISA kit (in the present study) were analyzed separately from those reactive with two ELISA kits (in the present study).Results:In this study, 140 (0.27%) donors who were reactive by anti HCV ELISA were included. Out of them, 35 were repeat voluntary donors and 16 (11.43%) were reactive with single ELISA kit. All 16 donors were reactive by single ELISA kit occasionally in previous donations. Their present ELISA positive donations were negative for HCV NAT and RIBA. A total of 19 (13.57%) donors were reactive with two ELISA kits. In their previous donations, the donors who were reactive even once with two ELISA kits were consistently reactive by the same two ELISA kits in their next donations also.Conclusion:Donor sample reactive by only single ELISA kit may not be considered as infectious for disposal as they were negative by NAT and or RIBA. One time ELISA positivity was found probably due to ELISA kit specificity and sensitivity. Donors reactive with two ELISA kit should be discarded as there is a high positivity with NAT/ RIBA. However, donors reactive by two ELISA kits and negative by NAT and RIBA should be followed up and may not be deferred permanently.

Hepatitis C virus RNA detection in serum and peripheral blood mononuclear cells of patients with hepatitis C.

To investigate the existence and clinical significance of hepatitis C virus (HCV) RNA in the serum and peripheral blood mononuclear cells (PBMC) of patients with hepatitis C. HCV RNA was detected by nested polymerase chain reaction (Nested PCR) in serum and in PBMC of 46 patients with acute hepatitis C (AHC) and in 42 patients with chronic hepatitis C (CHC). The positive rate of HCV RNA in PBMC of patients with CHC was markedly higher than that of patients with AHC (P < 0.01). The positive rates of HCV RNA in serum of patients with AHC and CHC and in PBMC of patients with CHC were significantly higher than those of anti-HCV positive patients with normal alanine aminotransferase (ALT) levels (P < 0.01). HCV RNA was negative in the serum of two patients, but could be detected in PBMC. In 12 patients, anti HCV was negative while HCV RNA was positive in serum. (1) detection of serum HCV RNA by nested PCR might be helpful in the early diagnosis of anti-HCV negative hepatitis C; (2) liver damage in patients with hepatitis C might be correlated with HCV-viremia; (3) infection of PBMC by HCV might play an important role in chronic liver damage in patients with HCV and in the chronicity of its clinical course; and (4) PBMC might be considered as a "reservoir" for HCV.

FREQUENCY OF HCV AND MEAN AGE

Objectives: To know the frequency of HCV in patients with cirrhosis and to know the mean age of patients with cirrhosis. Design: A descriptive study. Setting: Medical Unit Khyber Teaching Hospital Peshawar Period: From Jan 2007 to Jan 2008. Materials &amp; Methods: 100 consecutive cirrhotic patients or those with signs and symptoms of cirrhosis, admitted to the medical units. They were either known cirrhotic orhaving signs and symptoms of chronic liver disease and diagnosed as cirrhotic during their stay in the hospital on the basis of ultrasound findings. The routine investigations including liver function test (LFTs), prothrombin time (PT), activated partial thromboplastin time (APTT), serum albumin were carried out in all patients. Ultrasound was the main tool for the diagnosis of cirrhosis liver. The hepatitis C virus (HCV) statuswas diagnosed by detecting Anti HCV Antibodies by enzyme linked immunosorbent assay (ELISA). Polymerase chain reaction (PCR) for HCV RNA was done only in affording patients. Results: The overall frequency of HCV was 52 in 100 patients. Out of these 52 HCV positive patients, PCR for HCV RNA was positive in 20 patients (38.15%) and the rest of the patients were not able to afford the est. Out of 52 HCV positive patients the number of male were more (1.8:1) as compared to female. The age of the patients ranged from 45-65 years, the majority being from 45 to 65 years with the mean age of 52 years. The stratification of risk factors was not the objective of this study. However, a note was made of exposure to various risk factors. Most of the patients had the history of receiving injections in the past from quacks. Conclusion: It is concluded that chronic HCV infection is the commonest cause of cirrhosis leading to chronic ill health, great economic burden on family and health care system and mortality. As there is no treatment for cirrhosis so prevention, early detection of HCV infection and prompt treatment of HCV infected patients will undoubtedly lead to a decrease in morbidity and mortality from this silent epidemic.

Seroprevalance of anti-HCV among voluntary blood donors

The present study reports the prevalence of hepatitis C virus (HCV) infection among 70,200 voluntary blood donors. Out of them, 364 (0.52%) donors were anti-HCV positive of which 308(0.44%) were male and 56(0.08%) were female. As the donors were categorized by profession, highest number of voluntary donors were students (58%) followed by Business man (21%), Service holder (19 %) and house wife (2%). Most of the donors (43%) were in the age group of 18-25yrs. Among the professional groups of voluntary blood donors, percentage of anti HCV positive cases was highest in businessmen group (1.09%) followed by housewife (0.98%), service holders (0.73%) and students (0.22%).Bangladesh J Med Microbiol 2010; 03 (02): 1-3

Seroprevalence of HCV and its co-infection with HBV and HIV among liver disease patients of South Tamil Nadu

To determine the seroprevalence of hepatitis C virus (HCV) and its co-infection with hepatitis B virus (HBV), hepatitis delta agent (HDV) and human immunodeficiency virus (HIV) among liver disease patients of south Tamil Nadu. A total of 1012 samples comprising 512 clinically diagnosed cases of liver disease patients and 500 apparently healthy age and sex matched individuals were screened for Hepatitis C virus (anti HCV and HCV RNA), Hepatitis B virus (HBsAg), Hepatitis delta agent (anti HDV) and Human immuno virus (antibodies to HIV-1 and HIV-2) using commercially available enzyme linked immunosorbent assay kits. HCV RNA was detected by RT-PCR. Liver function tests like ALT, AST, GGT, ALP, bilirubin and albumin were also studied. The seroprevalence of HCV was found to be 5.6% among liver disease patients by ELISA. 27/512, 49/512 and 12/512 patients were positive for HIV, HBV & HDV respectively. Co-infection of HCV & HBV was found in 8 patients, with 6 for HCV & HIV and 4 for HCV, HBV & HIV co-infections. Sex-wise analysis showed that HIV, HCV & HBV and HCV & HIV co-infection was high among females whereas for HBV it was high in males. The mean ALT and AST in HCV positive cases were 42.1 ± 8.3 and 49 ± 10.1. In people co-infected with HCV & HBV or HCV & HIV or HCV, HBV & HIV the mean ALT of 58.0 ± 03.16, 56.78 ± 4.401 and 64.37 ± 4.01 respectively. We strongly recommend routine test of the blood for HCV in addition to HBV and HIV. We also recommend individualized counseling to identify those at risk and testing for those who want it. Improved surveillance and periodic epidemiological studies will have to be undertaken to monitor and prevent these blood-borne viruses.

Hepatitis C virus genotypes in chronic hepatitis C patients and in first time blood donors in northeastern Bosnia and Herzegovina.

Prevalence of hepatitis C virus (HCV) genotypes in Bosnia and Herzegovina (B&H) is an issue that is not sufficiently researched and there is a need for studies that would explore this in detail.The aim of this study was to determine the distribution of HCV genotypes in the group of patients with chronic hepatitis C and also in the group of first time blood donors that tested positive for anti HCV antibodies during the blood screening process. Our secondary goal was to compare the proportions of HCV genotypes between these two groups.We analyzed 75 blood samples of patients with confirmed chronic hepatitis C. We also analyzed 13/16082 blood samples of first time blood donors found to be HCV positive during the blood screening process. We also determined HCV genotype in HCV RNA positive samples.We have found that genotype 1b was more prevalent in chronic hepatitis C patients (52/75; 69,3%) than in first time blood donors (6/13; 46,1%), however this difference was not statistically significant (c2=1,721; df=1; p=0,19). Genotype 1a was more prevalent in the group of first time blood donors (3/13; 23,1%) than in the group of chronic hepatitis C patients (3/75; 4%), but this was also with limited statistical significance (c2=3,71; df=1; p=0,054). We have not found any significant difference in prevalence of genotypes 1a (p=0,2) and genotypes 3 (p=0,70) when compared between chronic patients (3/75 and 16/75; respectively) and first time blood donors (3/13 and 4/13; respectively). Our study confirmed domination of genotype 1b in the region of northeastern B&H which is in accordance with HCV genotype prevalence in other countries in our part of Europe.