HCV Seropositivity Research Articles

English

STUDY: To know the sero-positivity of Anti HCV and HbsAg in HIV positive patients. To compare it with the prevalence of Anti HCV and HbsAg positivity in normal persons. MATERIALS AND METHODS: This study was conducted on patients who were admitted to BTGH GULBARGA, meeting inclusion and exclusion criteria between 1-12-2012 to 31-5-2014, 110 patients infected with HIV were taken into the study. The patients belonged to both sexes and age range from 12 to 49 years. Detailed patient data including age, occupation, relevant history, examination finding were noted using prepared proforma and investigations like cbc, HIV, HbsAg, Anti HCV, LFT, were done and reports analyzed. 100 HIV negative persons with age and sex matched were taken as controls OBSERVATION: Out of 110 HIV positive patients 71 [64.54%] were males and 39 [35.46%] were males. In both sexes maximum number of cases was present in 40- 49 years age group. Males 23.63% and females 11.81%. Out of 110 HIV positive patients 14(12.72%) were positive to HbsAg and 5(4.54%) were positive for Anti HCV. None of them were positive to both HbsAg and Anti HCV Among the HIV positive patients HbsAg was seen more in age group 30-39yr(6) followed by 40-49yr (4) years of age, showing co-infection is more common in sexually active age group. Males were more positive to HbsAg than females.57.14% for males and 42.85.% for females. Maximum number of cases of HbsAg positive were in age group 20-29 in males (21.4%) and 40 49yr age group for females (2.8%]. Maximum number of Anti HCV antibody positive patients were in age group 30 -39 (3) followed by 40-49 (1) age group. This study shows the prevalence of HbsAg in HIV negative healthy individuals is 5% compared to 12 % for those in HIV positive patients. Anti HCV antibody was nil in controls compare to 4.54% in study group. This shows that HbsAg and Anti HCV antibodies are more common in patients having HIV infection.

Effects of Iron Chelating Therapy and / or HBV - Vaccination on β-Thalassemia Major Patients

Introduction: Thalassemia is a genetic inherited blood disorder in which the body makes abnormal hemoglobin with excessive destruction of red blood cells, which leads to anemia. For many years, hepatitis B virus was a major problem for patients with thalassemia substantially contracted from blood transfusions. The development of effective vaccine has further reduced the magnitude of the problem of hepatitis B. Iron chelators are used to remove excess iron that accumulates due to repeated blood transfusion. Aim of the work: To compare thalassemic patients either have or haven’t HCV with healthy persons as regards biochemical indices taking in consideration effect of vaccination against HBV or not and using iron chelating therapy or not by the studied persons. Methodology: A case control study in which 40 thalassemic, blood transfusion dependent patients were chosen randomly to act as a case group from thalassemic patients attending the VACSERA Company. The cases (40 patients) they were classified to patients having HCV, patients were HBV vaccinated ,other non vaccinated, using iron chelating therapyor don’t use it. Another 10 healthy and non thalassemic persons were chosen randomly among persons attending the same company as a control group to be matched with the case group. Results: 50% of studied thalassemic patients had HCV seropositivity. Biochemical blood indices which were found to be significantly elevated among thalassemic patients than controls were ALT, AST, ALP, GGT and LDH enzymes in addition to serum iron, ferritin and globulin mostly in HBV non-vaccinated and iron chelating therapy non dependent patients while, other biochemical indices which were significantly decreased among thalassemic patients compared to controls included: total cholesterol, total protein, albumin and albumin/globulin ratio mostly in HBV vaccinated and iron chelating non dependent patients. Conclusion: this study illustrated the effectiveness of iron chelators agentsand the importance of vaccination for reduction of morbidity and mortality.

The effect of HCV serological status on Doxorubicin based chemotherapy induced toxicity and disease-free survival in breast cancer patients

BackgroundBreast cancer and HCV are two frequent diseases in Egypt. There is a considerable probability of concurrent affection. This concurrence creates a subpopulation, which needs special evaluation and care. ObjectiveTo evaluate a subset of Egyptian breast cancer patients receiving Doxorubicin based adjuvant chemotherapy, with HCV seropositivity (group 2) compared to HCV seronegative patients (group 1). Methods102 breast cancer patients, planned to receive Doxorubicin based adjuvant chemotherapy, at the Oncology Department, Alexandria Faculty of Medicine, were recruited since June 2009. Pretreatment evaluation included serological testing for HCV. FAC Adjuvant chemotherapy was given for six cycles. ResultsHCV seropositivity was detected in 52 cases. Two cases in the seropositive group developed toxic hepatitis and discontinued treatment and follow up. The remaining 100 patients suffered comparable toxicities, except for more frequent liver enzyme elevations in the seropositive group. Diarrhea was also more frequent in the seropositive group. Treatment delays and dose reductions were more frequently observed in the seropositive group. The 36month disease-free survival and relapse pattern were not significantly different between the two groups. ConclusionPatients receiving chemotherapy should undergo screening for the virus. Most patients with HCV were able to tolerate chemotherapy and continue the initial chemotherapy plan, without a significant change in the toxicity profile or the natural course of their malignancy. Dose or regimen adjustments may be of help to less tolerant patients. A preemptive 10% initial Doxorubicin dose reduction might reduce the frequency of severe toxicity for selected patients. The assistance of a gastroenterologist in HCV positive breast cancer patients, planned for chemotherapy is important.

Incidence and correlates of hepatitis C virus infection in a large cohort of prisoners who have injected drugs.

BackgroundHepatitis C virus (HCV) infection is common among prisoners, particularly those with a history of injecting drug use (IDU). Incarcerated people who inject drugs frequently report high-risk injecting practices both in prison and in the community. In spite of rising morbidity and mortality, utilisation of HCV-related services in Australia has been persistently low. This study aimed to describe the incidence, prevalence and correlates of HCV seropositivity in a large cohort of prisoners who have injected drugs, and to identify correlates of receiving confirmation of active infection.MethodsData-linkage to a State-wide statutory notifiable diseases surveillance system was used to investigate the incidence of notified HCV seropositivity, seroconversion and confirmed HCV infection in a cohort of 735 prisoners with a history of IDU, over 14 years of follow up. Hepatitis C test results from prison medical records were used to identify correlates of testing positive in prison.ResultsThe crude incidence of HCV notification was 5.1 cases per 100 person-years. By the end of follow up, 55.1% of the cohort had been the subject of a HCV-related notification, and 47.4% of those tested in prison were HCV seropositive. In multivariable analyses, injecting in prison was strongly associated with HCV seropositivity, as was opioid use compared to injection of other drugs. The rate of reported diagnostic confirmation among those with notified infections was very low, at 6.6 confirmations per 100 seropositive participants per year.ConclusionsInjecting drugs in prison was strongly associated with HCV seropositivity, highlighting the need for increased provision of services to mitigate the risk of transmission within prisons. Once identified as seropositive through screening, people with a history of IDU and incarceration may not be promptly receiving diagnostic services, which are necessary if they are to access treatment. Improving access to HCV-related services will be of particular importance in the coming years, as HCV-related morbidity and mortality is increasing, and next generation therapies are becoming more widely available.

Impact of Live Organ Donor Screening On Donation Yield: A Single Center Retrospective Assessment.

Background: Although exceedingly rare, transmission of infectious diseases (ID) from potential live organ donors (PLOD) to transplant recipient occurs. Recently, guidance and policy has resulted in increased PLOD screening. It is recommended that PLODs at increased risk of ID transmission be rescreened for HIV, HBV and HCV within 30 days of the donation procedure. Further, OPTN policy has been enacted requiring PLOD screening, including screening for Strongyloides, TB, T. cruzi and West Nile Virus (WNV). The yield and outcomes of such testing has not been reported. Methods: Testing results and dates from all PLODs evaluated at Northwestern Memorial Hospital 1/1/08-12/31/13 were extracted from the EMR. Descriptive statistics were calculated Results: During the study period, 3414 PLODs were evaluated (2824 kidney and 591 liver PLODs). During this period, 919 kidney and 107 liver PLODs proceeded to donation (See Table 1). +HBsAg resulted in PLODs being excluded as donors; HCV sero+ triggered additional testing that contributed an additional 23 days to the time from evaluation to decision. Rates of CMV sero+ among donors are lower among PLODs than deceased donors at our center (data not shown). 2.9% of PLODs who proceeded to donation were classified as increased risk per OPTN policy (mostly MSM). 9-14% of PLODs who proceeded to donation were QGold +, most with risk factors; +QGold was associated with an average of 56 day delay to donation. Treatment was offered to all QGold + PLODs but donation was not defer in PLODs without evidence of active tuberculosis. No donor-derived disease transmissions were recognized among this population of live donor recipients.Table: No Caption available.Discussion: HCV seropositivity and +QGold resulted in delays in donor evaluation. Retesting of increased risk PLODs did not result in significant delays or cancellations. Screening for Strongyloides, T. cruzi and WNV had a low yield in this population. +QGold live donors can be safely utilized without completing treatment for latent TB.

Hepatitis C virus seropositivity and genotyping by RealTime PCR in a tertiary care hospital in Southern India

Background Hepatitis C virus is one of the major causes of parenterally acquired hepatitis. HCV genotypes exhibit different profiles of pathogenicity, infectivity and response to antiviral therapy. The study was taken up to detect HCV seropositivity and common genotype prevalence in a tertiary care hospital. The other objectives of the study were to detect probable risk factors and HIV/HBV co infections.

Risk factors for vitamin D deficiency among HIV-infected and uninfected injection drug users.

IntroductionVitamin D deficiency is highly prevalent and is associated with bone disease, cardiovascular disease, metabolic syndrome and malignancy. Injection drug users (IDUs), with or without HIV infection, are at risk for these conditions; however, limited data on vitamin D deficiency exist in this population. We determined the prevalence and correlates of vitamin D deficiency among urban IDUs in the AIDS Linked to the IntraVenous Experience (ALIVE) Study cohort.MethodsFor this cross-sectional sub-study, vitamin D deficiency was defined as a serum 25(OH)-vitamin D level <20 ng/mL. Multivariable logistic regression was used to identify factors independently associated with vitamin D deficiency.ResultsOf 950 individuals analyzed, 29% were HIV-infected. The median age was 49 years; 65% were male, and 91% were black. The median vitamin D level was 13.5 ng/mL (IQR, 9.0–20.3); 74% were deficient (68% in HIV-infected vs. 76% in HIV-uninfected, p = 0.01). Non-black race, fall/winter season, multivitamin intake, higher serum albumin, HCV seropositivity and HIV-infection were associated with significantly lower odds of vitamin D deficiency.ConclusionsVitamin D deficiency is prevalent among IDUs. Notably, HIV-infected IDUs were less likely to be vitamin D deficient. Higher vitamin D levels were associated with multivitamin intake and with higher albumin levels, suggesting that nutritional status contributes substantially to deficiency. The association between HCV serostatus and vitamin D level remains unclear. Further investigation is needed to define the clinical implications of the heavy burden of vitamin D deficiency in this high-risk, aging population with significant co-morbidities.

Prevalence of viral hepatitis in Croatian adult population undergoing routine check-up, 2010-2011.

Seroprevalence data on viral hepatitis in the general population vary widely. The aim of this study was to determine the prevalence of hepatitis A (HAV), hepatitis B (HBV) and hepatitis C (HCV) viruses in the general Croatian adult population undergoing routine check-ups. The seroprevalence of anti-HAV, anti-HBc and anti-HCV was 40.5%, 7.0% and 0.9%, respectively. HBsAg was found in 0.7% and anti-HBs antibodies in 24.4% of participants. Gender was not associated with HAV, HBV or HCV seropositivity. HAV and HBV seropositivity increased progressively with age (HAV from 11.7% to 90.4%, p < 0.001; HBV from 1.7% to 15.8%, p < 0.001). Participants from rural areas showed a significantly higher HBV seroprevalence rate than those from urban areas (10.7% vs. 6.1%, p = 0.007). Results of univariate and multiple logistic regression showed that older age was a significant predictor for both HAV and HBV seropositivity while rural place of residence was a significant predictor for HBV seropositivity.

Seroprevalence of HIV, HBV and HCV among the Cadaver Population - A Jaipur Based Study

Forensic medical personnel are at risk of exposure to blood-borne viruses including HIV, Hepatitis B and Hepatitis C virus. The aim of this study was to determine seropositivity of HIV, HBV and HCV among a cadaver population at the SMS hospital, Jaipur. The study group consists of Four hundred eighteen randomly picked subjects over a period of one year from October 2008 to September 2009. These cadavers were screened for HIV antibodies, HBs Antigen (hepatitis B surface antigen) and HCV antibodies (hepatitis C virus antibodies) by applying ELISA Test. For HIV antibodies initial reactive tests were confirmed by Tridot Test and SD Bioline test as per NACO guideline. The maximum numbers of deceased in the present study group were in the age range of 15–44 years being 295 in number (70.58%). Out of these, 224 (75.9%) were males and 71 (24.06%) were females. In all 46 (11.0%) samples out of 418 were seropositive for HIV, HBV and HCV infections. From 418 subjects, 10 were seropositive for HIV (2.39%) all of them males. Seropositivity for HCV was found in 7(1.67%); males only. Out of 29 subjects seropositive for HBV, majority i.e. 17 (58.62%) were in age range of 15–44 years. In the serological status of HBV, 29(6.94%) subjects showed positive results. Among them 21 were males and 8 were females. All forensic cadavers should be treated as potentially infectious and universal precautions should be taken.

Prevalence of past and reactivated viral infections and efficacy of cyclosporine A as monotherapy or in combination in patients with psoriatic arthritis--synergy study: a longitudinal observational study.

We have prospectively evaluated psoriatic arthritis (PsA) patients for (1) seropositivity for former viral infections and seroconversion and (2) efficacy of cyclosporine A (CsA) alone or in combination with other immunosuppressants in a time period of 12 months. Screening included HBV antibodies and antigens, HCV antibodies and RNA, HSV 1-2, HZV, EBV, and CMV IgG, and IgM, HHV-6 DNA, and HIV 1-2 antibodies. PsA was evaluated by the Psoriasis Area Severity Index (PASI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and the Visual Analogue Scale (VAS). At baseline, 126 (56%) out of 225 evaluable patients had 2 or more seropositivities indicative of former infections, and 31 patients (13.8%) presented seropositivity for HCV, HBV, HSV-1 and -2, HHV-6, EBV, or parvovirus infection; one of them, positive for HBAg, was treated with lamivudine, while the remaining 30 received no specific treatment. None of the 31 patients developed virus reactivation. A reduction (P < 0.001) of PASI, BASDAI, and VAS scores was observed at 6 and 12 months. The treatment of PsA with CsA as monotherapy or in combination was safe and effective. In vitro experiments and clinical findings, including those from our study, suggest that CsA as monotherapy or in combination with biologics might be the treatment of choice in PsA HCV-positive patients.

Cardiovascular manifestations of hepatitis C virus infection

Introduction: Hepatitis C virus infection is a major global health problem being the second most common chronic virus infection. It is associated with numerous extra hepatic manifestations of which cardiovascular diseases constitute an important but under diagnosed aspect of the infection. Aim: This study was carried out to evaluate the association between cardiovascular manifestation and HCV seropositivity patients attending Regional Institute of Medical Sciences (RIMS) in Imphal, Manipur. Materials and Methods: From august 2009 to july 2011, 50 HCV seropositive patients in the department of Medicine, Regional Institute of Medical Sciences, Imphal were evaluated. They were subjected to thorough physical examination and baseline laboratory investigations. Above that, echocardiogram was done for each patient. For statistical analysis of data, statistical package for the social sciences (SPSS16.0 version) and student's t-test was used. Results: In this study, the average age of patients was 44 years, ratio of males to females was 3.5: 1. HCV infection is more common in males who are in the sexually active and married age group 30 to 49 years. In the laboratory parameters high serum glutamic pyruvic transaminase (SGPT) and high erythrocyte sedimentation rate (ESR) were significant indicators of cardiac chamber (left atrial and left ventricular) enlargement and left ventricular diastolic dysfunction in HCV seropositive patients. Conclusion: The result corroborated favorably that the more progressed is the inflammation and liver dysfunction due to HCV infection, the more likely to have cardiovascular changes of cardiac chamber enlargement and left ventricular diastolic dysfunction.

Virologic and histologic characterisation of dual hepatitis B and C co-infection in Egyptian patients

Background and study aimsData about dual hepatitis C (HCV) and B (HBV) co-infection are still scarce, especially in endemic areas such as Egypt. Therefore, we aimed to characterise the virologic and histologic pattern of dual B/C co-infection in a tertiary care centre in Egypt. Patients and methodsAfter obtaining approval from the review board, a retrospective design to evaluate the data registry between January 2009 and December 2012 of patients with dual HCV and HBV seropositivity (BC-group) at the Viral Hepatitis Unit in Ministry of Health and Assiut University Hospital, Egypt was conducted. Data for hepatitis B e antigen (HBe-Ag) and anti-HB core status, anti-hepatitis delta virus (anti-HDV), HBV-DNA and HCV-RNA assays and liver biopsy (METAVIR scoring) results were collected. Two other matched groups of mono-HCV (C-group) and HBV (B-group) were selected as controls. All patients were naive for antiviral therapy. ResultsA total of 3300 patients were enrolled. Dual infection was observed in 25 (0.7%) patients (all males, mean=35.2±10.2years). Four patients (16%) were HBe-Ag-positive. Six (24%) patients were HBV-DNA-negative and all were positive for HCV RNA. Between groups, raised alanine aminotransferase (ALT) was found in 76%, 41.7% and 49.2% of the BC, B and C groups, respectively (p=0.023). HBV DNA >2000IUml−1 was more in the B-group than in the BC-group (63.9% vs. 36%; p=0.042) and HCV RNA >800,000IUml−1 was more in the BC-group than in the C-group (28% vs. 12.3%; p=0.009). Histologically, there is no statistical significant difference between the three groups. ConclusionDual hepatitis B/C infection is not uncommon and their virologic and histologic profile is modest. Further evaluation with regard to treatment and long-term follow-up is warranted.

Blood donor recruitment strategies and their impact on blood safety in Egypt

Because of the high incidence of HCV, blood safety presents a serious challenge in Egypt. Given the constrained economy which limits the implementation of nucleic acid amplification technology, proper recruitment of blood donors becomes of paramount importance. To evaluate the effectiveness of blood donor recruitment strategies, the seroprevalence of positive infectious markers among blood donors was studied. Donors' records covering the period from 2006-2012 were reviewed. Blood donations were screened for HCV antibodies, HBs antigen (HBsAg), HIV-1 and 2 and syphilis antibodies. Of 308,762 donors, 63.4% were voluntary donors (VD). VD of 2011-2012 were significantly younger than family replacement donors (RD) .The overall prevalences of HCV antibodies, HBsAg, HIV and syphilis antibodies were 4.3%, 1.22%, 0.07%, and 0.13%, respectively. All tested markers (except HIV) were significantly higher among RD, when compared to VD (P<0.0001). A consistent steady trend for decrease in HCV seropositivity was observed in RD and VD from 8.9% and 4.2% to 3.8% and 1.5%, respectively. A trend for decrease in HBsAg was demonstrated in VD from 1.2% to 0.53%. The decreasing trends in HCV antibody and HBs antigen is promising and may reflect the improved donor selection criteria.

Interim Analysis Of An Ongoing PHASE II Trial Assessing Safety and Efficacy Of Lenalidomide Maintenance In Patients With Chemosensitive Relapse Of Diffuse Large B-CELL Lymphoma (DLBCL)

IntroductionPatients (pts) with relapsed DLBCL who can not be managed with consolidative autologous or allogeneic transplantation exhibit a poor prognosis. Despite a high response rate to induction chemo(immuno)therapy, these pts invariably experience early relapse and die of lymphoma progression. Single-drug maintenance may be a good alternative to intensified consolidation to prolong response duration in these pts. Lenalidomide is an oral immunomodulator, active against DLBCL, which can be taken for several years with an excellent safety profile. Accordingly, we designed a multicenter phase II trial addressing safety and efficacy of lenalidomide maintenance in pts with chemosensitive relapse of DLBCL who are not suitable for intensified consolidation or experienced a failure after autologous transplant (NCT00799513). Herein, we report the interim analysis on the first 17 enrolled pts. MethodsSelection criteria were: 1) adult HIV-negative pts; 2) histologically-proven de novo or transformed DLBCL; 3) relapsed disease responsive (partial or complete response) to conventional salvage therapy; 4) ECOG PS ≤3; 5) time to progression from the previous line ≥3 months. Pts with CNS involvement, HBV-DNA or HCV-RNA positivity or active infections were excluded. After confirmation of objective response to salvage therapy, pts were registered and treated with lenalidomide 25 mg/day once daily for 21 days out of 28, for two years or until lymphoma failure or unacceptable toxicity. Primary endpoint was the 1-year PFS. With the null hypothesis (P0) of 1-year PFS of 30%, this study will consider a satisfactory efficacy of lenalidomide a P1 corresponding to a 1-yr PFS of 50%, 47 pts will be needed (α: 0,05; β: 80%). Results17 pts were enrolled (median age 73, range 52-86; M:F ratio: 1.1). Eleven pts had a de novo DLBCL, 6 had a transformed DLBCL. Fifteen pts were enrolled after the first relapse, two pts after the 3rd and 4th relapse. All pts experienced a relapse after anthracycline- and rituximab-based chemotherapy, with a median time to progression after the previous line of 16 months (range 6-88). Only one patient was previously managed with autologous transplant. Most pts had unfavourable features: IPI ≥2 in 15 cases, advanced stage in 14, extranodal disease in 13, high LDH in 7. Two pts had bone marrow infiltration; one had HCV and HBc seropositivity. Salvage chemotherapy consisted of high-dose-cytarabine-based combinations in 12 pts, high-dose-ifosfamide-based regimens in 3 and anthracycline-based regimens in 2; all pts received rituximab as part of salvage therapy. Response to salvage therapy was complete in 12 pts and partial in 5.Three pts completed the planned maintenance, treatment is ongoing in 4; 3 pts interrupted maintenance due to lymphoma relapse, treatment was interrupted due to toxicity in 7 pts (diarrhoea in 3, rash in 2, prolonged neutropenia, anorexia) after 3, 10, 14, 6, 8, 12, and 1 course, respectively. Eight pts needed a transient dose reduction to 10 or 15 mg/d due to rash (n=5), neutropenia (n=2) and neuropathy. There were 4 SAEs (febrile neutropenia and diarrhoea) in 3 pts. Grade 3-4 haematological toxicity consisted of neutropenia in 7 pts and thrombocytopenia in 2. Grade 3-4 non-haematological toxicity consisted of diarrhoea in 3 pts and rash in 5.Four of the 5 pts in partial response after induction chemoimmunotherapy achieved a complete remission during maintenance. At the last delivered lenalidomide course, 14 (82%; 95%CI: 64-100%) pts were in complete remission, and 3 pts experienced progressive disease, with a median response duration of 26+ months. At a median follow-up of 23 months, 12 (71%) pts remained in complete remission, two responders experienced relapse (27 & 34 months). The 1-year (primary endpoint) PFS was 79% for the whole series. Pts who received at least six lenalidomide courses had a 2-year PFS of 90%. Dose reductions were non influential on PFS (1-year: 75% vs. 83%). All pts are alive (NED in 14). ConclusionsLenalidomide maintenance is feasible and well tolerated in pts with relapsed DLBCL. As expected, diarrhoea and rash remain frequent dose-limiting side effects in this elderly population. With obvious limitations, this interim analysis shows encouraging PFS figures, with long-lasting remission in most pts who received at least six lenalidomide courses. Accrual completion is warranted. Disclosures:No relevant conflicts of interest to declare.

CCR5 Haplotypes Influence HCV Serostatus in Caucasian Intravenous Drug Users

BackgroundUp to 90% HIV-1 positive intravenous drug users (IDUs) are co-infected with HCV. Although best recognized for its function as a major co-receptor for cell entry of HIV, CC chemokine receptor 5 (CCR5) has also been implicated in the pathogenesis of HCV infection. Here, we investigated whether CCR5 haplotypes influence HIV-1 and HCV seropositivity among 373 Caucasian IDUs from Estonia.MethodsOf these IDUs, 56% and 44% were HIV and HCV seropositive, respectively, and 47% were coinfected. 500 blood donors seronegative for HIV and HCV were also evaluated. CCR5 haplotypes (HHA to HHG*2) were derived after genotyping nine CCR2–CCR5 polymorphisms. The association between CCR5 haplotypes with HIV and/or HCV seropositivity was determined using logistic regression analysis. Co-variates included in the models were length of intravenous drug use, HBV serostatus and copy number of CCL3L1, the gene encoding the most potent HIV-suppressive chemokine and ligand for CCR5.ResultsCompared to IDUs seronegative for both HCV and HIV (HCV−/HIV-), IDUs who were HCV+/HIV- and HCV+/HIV+were 92% and 82%, respectively, less likely to possess the CCR5-HHG*1 haplotype, after controlling for co-variates (Padjusted = 1.89×10−4 and 0.003, respectively). This association was mostly due to subjects bearing the CCR5 HHE and HHG*1 haplotype pairs. Approximately 25% and<10% of HCV−/HIV- IDUs and HCV−/HIV- blood donors, respectively, possessed the HHE/HHG*1 genotype.ConclusionsOur findings suggest that HHG*1-bearing CCR5 genotypes influence HCV seropositivity in a group of Caucasian IDUs.

Epidemiology of hepatitis B and hepatitis C virus infections in pregnant women in Sana'a, Yemen.

BackgroundScreening for Hepatitis B and C during pregnancy may help to decide on appropriate antiviral therapy and the institution of steps to minimize vertical transmission to the newborn infants.MethodsA cross-sectional study was conducted during November–December 2011 to investigate the seroprevalence and associated risk factors for markers of HBV (hepatitis B surface antigen; HBsAg) and anti-HCV antibody among pregnant women at the Al-Thawra hospital in Sana’a, Yemen. Structured questionnaires were used to obtain sociodemographic obstetrics and medical data and sera were tested for HBsAg and anti-HCV.ResultsOf the 400 pregnant women enrolled in the study, HBsAg and anti-HCV were detected in 43 (10.8%; 95% CI: 8.0–14.0%) and 34 (8.5%, 95% CI: 6.0–11.5%) women, respectively. None of the women were co-infected with HBV and HCV. Multivariate analysis showed that circumcision was significantly associated with HBsAg seropositivity (OR = 3.3, 95% CI: 1.1–10.2; p = 0.03), low parity (primigravidae and secundigravidae) and education below secondary level were significantly associated with anti- HCV seropositivity (OR = 3.3, 95% CI: 1.1–10.2; p = 0.03). No other sociodemographic or clinical characteristics (age, residence, history of home delivery, miscarriage, dental manipulation, surgery, and blood transfusion) were significantly associated with HBsAg or anti-HCV seropositivity.ConclusionThe results of this study suggest that HBsAg and anti-HCV have high prevalence among pregnant women.

The effect of HCV serological status on doxorubicin-based chemotherapy-induced toxicity and disease-free survival in breast cancer patients.

1075 Background: Breast cancer and HCV are two frequent diseases in Egypt. There is a considerable probability of concurrent affection. This concurrence creates a subpopulation which needs special evaluation and care. Methods: To evaluate a subset of Egyptian breast cancer patients receiving doxorubicin based adjuvant chemotherapy, with HCV seropositivity (Group 2) compared to HCV seronegative patients (Group 1). 102 breast cancer patients, planned to receive Doxorubicin based adjuvant chemotherapy, at the Oncology Department, Alexandria Faculty of Medicine, were recruited since June 2009. Pretreatment evaluation included serological testing for HCV. FAC adjuvant chemotherapy was given. Results: HCV seropositivity was detected in 52 cases. Two cases in Group 2 developed toxic hepatitis and discontinued treatment and follow up. The remaining 100 patients suffered comparable toxicities, except for more frequent SGOT and SGPT elevations in Group 2. Diarrhea was more frequent in Group 2. Treatment delays and dose reductions were more frequently observed in Group 2. The 24 month disease-free survival and relapse pattern were not significantly different between the two groups. Conclusions: Patients receiving chemotherapy should undergo screening for the virus. Most patients with HCV were able to tolerate chemotherapy and continue the initial chemotherapy plan, without significant change in the toxicity profile or the natural course of their malignancy. Dose or regimen adjustments may be of help to less tolerant patients. A preemptive 10% initial Doxorubicin dose reduction might reduce the frequency of severe toxicity. The assistance of a gastroenterologist in HCV positive breast cancer patients, planned for chemotherapy is important.

Discordant hepatitis C serological testing in Australia and the implications for organ transplant programs

BackgroundDiscordant and equivocal hepatitis C (HCV) serology testing is problematic for making decisions regarding deceased organ donor (DOD) transplant allocation based on allograft infection status. ObjectivesThis study aimed to analyse the prevalence and follow-up testing of discordant HCV tested patients from an Australian population at increased risk of HCV infection, with prevalence modelling for the Australian DOD population. Study designDe-identified patient discordant HCV serology results (primary chemiluminescent microparticle immunoassay and secondary Bio-Rad MonoLisa HCV Ag/Ab Ultra assay) were retrospectively identified in a general referral laboratory between May 2008 and August 2011. Prior and follow-up serology testing was reviewed. Discordant result prevalencewas calculated using Bayes’ theorem for the DOD population using Australian DOD rates and HCV seroprevalence. ResultsThe tested population had a 6.6% HCV seroprevalence. The rate of discordant serotesting was 0.54%, with no cases identified as having definite HCV infection at follow-up. Two patients had evidence of definite HCV seropositivity before the index discordant test. Modelling for the Australian DOD population of 337 per year estimated a discordant test prevalence of 1.8 per year. ConclusionsDiscordant HCV serotesting may occur for 1 of 185 patients tested in higher risk populations. The majority of such tests represent falsely reactive tests although a small number may reflect partial seroreversion. Amongst Australian DOD, this represents 1 or 2 discordant cases per year. It is likely that if this discordant sample were from a donor with no blood borne virus risk factors, and was concurrently RNA negative, that HCV infectious risk would be extremely low.

Racial Disparities in Post-Transplant Survival Among Renal Transplant Recipients with Pre-Transplant Hepatitis C Seropositivity

Background & Aims: Substantial epidemiological evidence exists for a relationship between hepatitis c virus (hcV) seropositivity and adverse outcomes among renal transplant (RT) recipients. however, data on whether gender or ethnicity modulates this association is relatively scarce. Methods: We did a post-hoc analysis of the limited access dataset of United Network for Organ Sharing/ Organ Procurement and Transplantation Network. All adult RT recipients with complete details on the hcV serostatus and follow-up (n=169,261) were included in the analysis. All simultaneous transplants were excluded. Univariate analysis was done to determine the significant predictors of survival. cox proportional hazards model was used to adjust for significant risk predictors. Results: A total of 169,261 patients were included in the analysis. Mean age was 48±13 years. There were 10,238 hcV seropositive recipients, of which 2192 (21.5%) died over a mean follow up of 4 yrs. In the multivariate analysis, hcV seropositivity was independently associated with post-transplant survival in the overall cohort. Among hcV patients, when compared to African-Americans, caucasians were at increased risk of all-cause mortality (hR: 1.18, 95% cI: 1.06 to 1.31; p=0.002). however, there were no statistically significant differences in overall survival in hcV positive patients among other races. Conclusions: Our study identifies a possible racial difference in all-cause mortality among hcV seropositive renal transplant recipients. This could possibly be explained by the difference in immunologic response among different races. The impact of viral eradication in this population has to be quantified by further research. Immunogastroenterology 2013; 2:173-176

Prevalence of Type 2 Diabetes Mellitus in Hepatitis C Virus Infected Population: A Southeast Asian Study

Purpose. The study was aimed to investigate the frequency of diabetes mellitus type 2 in patients infected with chronic hepatitis C virus and its association with cirrhosis. Patients and Methods. This prospective case series was conducted at Section of Gastroenterology and Hepatology, Isra University Hospital, Hyderabad, over a period of 4 months from June 2009 to October 2009. Hepatitis C virus seropositive patients who were older than 18 years, diabetic or nondiabetic, were included. Basic demographic data collected by questionnaire and laboratory investigations including fasting blood glucose levels, serum cholesterol, and liver function tests were done. A logistic regression model was used to explore the association between diabetic and nondiabetic HCV seropositives and type 2 diabetes mellitus with cirrhosis. Results. A total of 361 patients with hepatitis C were analyzed; the prevalence of type 2 diabetes mellitus in HCV patients was 31.5%. Out of the total number of the participants, 58.4% (n = 211) were cirrhotics, while 41.6% (n = 150) were noncirrhotic HCV seropositives. In multivariate analysis, cirrhotic patients appeared significantly more likely (P = 0.01) to be diabetic as compared with noncirrhotic patients (OR = 2.005, 95% CI: 1.15, 3.43). Conclusion. Advancing age, increased weight, and HCV genotype 3 are independent predictors of type 2 diabetes in HCV seropositive patients, and there is a statistically significant association of cirrhosis observed with type 2 diabetes mellitus.