scholarly journals Anti-Glutamic Acid Decarboxylase Antibody-Associated Ataxia as an Extrahepatic Autoimmune Manifestation of Hepatitis C Infection: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-4
Author(s):  
Amer Awad ◽  
Olaf Stüve ◽  
Marlyn Mayo ◽  
Rafeed Alkawadri ◽  
Bachir Estephan

Extrahepatic immunological manifestations of hepatitis C virus (HCV) are well described. In addition, antiglutamic acid decarboxylase (GAD) antibody-associated cerebellar ataxia is well-established entity. However, there have been no reports in the literature of anti-GAD antibody-associated ataxia as an extrahepatic manifestation of HCV infection. We report the case of a young woman with chronic hepatitis C virus and multiple extrahepatic autoimmune diseases including Sjögren syndrome and pernicious anemia who presented with subacute midline cerebellar syndrome and was found to have positive antiglutamic acid decarboxylase (GAD) antibody in the serum and cerebrospinal fluid. An extensive diagnostic workup to rule out neoplastic growths was negative, suggesting the diagnosis of nonparaneoplastic antiglutamic acid decarboxylase antibody-associated cerebellar ataxia as an additional extrahepatic manifestation of hepatitis C virus infection. The patient failed to respond to high-dose steroids and intravenous immunoglobulin. Treatment with the monoclonal antibody rituximab stabilized the disease. We postulate that anti-GAD associated ataxia could be an extrahepatic manifestation of HCV infection.

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
James A. Ndako ◽  
Akinyomade O. Owolabi ◽  
Joseph A. Olisa ◽  
Jeremiah A. Akinwumi ◽  
Victor T. Dojumo ◽  
...  

Abstract Background Hepatitis C virus (HCV) infection and type 2 diabetes mellitus (T2DM) are two major public health problems associated with increasing complications and mortality rates worldwide. The objective of this study is to evaluate the prevalence of hepatitis C virus (HCV) infection in diabetic patients and to investigate the influence of several epidemiological and clinical factors on HCV infection. Method A total number of one hundred and eighty diabetic patients were recruited for this study. Consented subjects made up of 71(39.4%) males and 109(60.56%) females were recruited for the study. While one-Hundred (100) Non-Diabetics (Controls) were also recruited for the study. Structured questionnaires were administered to the consented participants to obtain relevant data. Sera samples were assayed for antibodies to HCV using an enzyme linked immunosorbent assay [Inteco Diagnostic Limited]. ELISA technique. Result Overall prevalence of HCV infection among diabetes patients assayed was 13.3% out of which 8(11.3%) was obtained from the male subjects compared to 16 (14.7%) seropositivity recorded among the females (P = 0.511; P > 0.05). Considering age distribution, Subjects aged 41–50 years recorded, 9 (22.5%) positivity (P = 0.238; P > 0.05).Considering educational status of subjects screened, 22 (14.9%) positivity was rescored among subjects who have attained tertiary status of education.(P = 0.574;P > 0.05).Risk factors considered showed that, 7 (18.9%) seropositive subject were alcoholic consumers(P value = 0.2621;P > 0.05) while 5 (8.9%) recorded history of sharing sharp objects P = 0.2427;P > 0.05). Conclusion Our study shows a slightly higher prevalence of hepatitis C infection in type 2 diabetics. This call for urgent routine screening exercise among diabetic patients for HCV infection. This study also emphasizes the need for public enlightenment on the association between HCV infection and T2DM, to avert possible complications among diabetic patients.


2004 ◽  
Vol 48 (8) ◽  
pp. 2876-2882 ◽  
Author(s):  
Der-Ren Hwang ◽  
Yuan-Chin Tsai ◽  
Jin-Ching Lee ◽  
Kuo-Kuei Huang ◽  
Ren-Kuo Lin ◽  
...  

ABSTRACT Hepatitis C virus (HCV) is a serious global problem, and present therapeutics are inadequate to cure HCV infection. In the present study, various antiviral assays show that As2O3 at submicromolar concentrations is capable of inhibiting HCV replication. The 50% effective concentration (EC50) of As2O3 required to inhibit HCV replication was 0.35 μM when it was determined by a reporter-based HCV replication assay, and the EC50 was below 0.2 μM when it was determined by quantitative reverse transcription-PCR analysis. As2O3 did not cause cellular toxicity at this concentration, as revealed by an MTS [3-(4,5-dimethylthiozol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium, inner salt] assay. A combination of As2O3 and alpha interferon exerted synergistic effects against HCV, as revealed by a multiple linear logistic model and isobologram analysis. Furthermore, in an alternative HCV antiviral system that may recapitulate additional steps involved in HCV infection and replication, As2O3 at 0.3 μM totally abolished the HCV signal, whereas alpha interferon at a high dose (5,000 IU/ml) only partially suppressed the HCV signal. The study highlights the indications for use of a novel class of anti-HCV agent. Further elucidation of the exact antiviral mechanism of As2O3 may lead to the development of agents with potent activities against HCV or related viruses.


2019 ◽  
Vol 72 (5) ◽  
pp. 928-932
Author(s):  
Nataliia O. Iakovenko ◽  
Maksim Y. Zak ◽  
Mykola O. Klymenko ◽  
Svetlana V. Zhuk ◽  
Olena K. Nuzhna

Introduction: Hepatitis C virus (HCV) infection is a major global problem. According to WHO, 150-200 million people globally have hepatitis C infection. Even though HCV infection morbidity rate in children is relatively low in comparison with the adult population, approximately 5 million children in the world have active HCV. There is a number of differences between HCV infection in adults and in children. However, the data pertaining to this issue is controversial. The aim: Research, analysis and synthesis of information from contemporary literature on transmission of infection and characteristics of the course of HCV infection in children. Materials and methods: Analysis and synthesis of information from contemporary literature on transmission of infection and characteristics of the course of HCV infection in children were conducted. Conclusions: Information from literature of the latest years on peculiarities of infection, disease course and complications of HCV infection in children was analyzed and summarized in this article.


2018 ◽  
Vol 10 (2) ◽  
pp. 37-41
Author(s):  
Farrokh Rad ◽  
Ebrahim Ghaderi ◽  
Bahram Nikkhoo ◽  
Mohammad Aziz Rasouli

Abstract Introduction. Hepatitis C virus (HCV) infection is one of the factors which can lead to a chronic liver disease and hepatocellular carcinoma. There have been several reports on the association of oral lichen planus with hepatic disorders, i.e. hepatitis C infection in particular. Considering the controversies about the association of lichen planus with HCV infection on one hand and considerable impact of hepatitis C on the occurrence of chronic liver disease on the other hand, we investigated the association between lichen planus and HCV infection in Sanandaj City. Methods. This cross sectional study included 168 patients with lichen planus, who were referred to the Dermatology Clinic of Besat Hospital between 2014 and 2016. The diagnosis of lichen planus was made by our dermatologist and HCV antibody titer was determined for every patient. Results. Mean age of the patients was 39.7±13.3 years and mean duration of the disease was 14.8 months. 107 (63.7%) patients were men. The highest frequency of lichen planus was recorded in the housewives (30.4%). In 52 (31%) patients the genital area was involved and it was the most common site. In 6 (3.6%) patients the oral mucosa was involved and it was the least common site in our study. Only 4 (2.7%) patients had family history of lichen planus. None of 168 patients included in this study was found to have HCV infection. Conclusion. In this study, we found no relationship between lichen planus and HCV infection. Yet, the exact mechanism underlying the occurrence of lichen planus in the patients with HCV infection has not been determined. Therefore more studies on this subject are recommended.


2011 ◽  
Vol 57 (7) ◽  
pp. 1050-1056 ◽  
Author(s):  
Keane KY Lai ◽  
Ming Jin ◽  
Shan Yuan ◽  
Meaghan F Larson ◽  
Jason A Dominitz ◽  
...  

BACKGROUND Chemiluminescence immunoassay (CIA) is used to detect hepatitis C virus (HCV) antibody status on the basis of signal-to-cutoff (S/Co) ratios. Positive results of antibody to HCV (anti-HCV) are followed by either recombinant immunoblot assay (RIBA) to confirm anti-HCV positivity or reverse transcription (RT)-PCR to detect viremia. We hypothesized that by analyzing S/Co ratios, we could determine a strategy to reduce unnecessary supplementary testing in our population. METHODS CIA was performed to screen for anti-HCV, and positive results were followed up with RT-PCR testing. Negative RT-PCR results were followed up with RIBA, whereas positive RT-PCR results were assumed to be RIBA positive. ROC curves were analyzed to determine the optimal S/Co ratios to predict HCV infection. RESULTS We determined the S/Co ratios on 34 243 veteran patient samples. We found that with the CIA method 9.0% of patients had positive test results for anti-HCV. An S/Co ratio <3.0 ruled out active HCV infection and exposure with 100% negative predictive value. When the S/Co ratio was ≥20.0, positive predictive values were 98.5% compared with RIBA results, and 81.0% compared with RT-PCR results. CONCLUSIONS RIBA is not necessary to confirm negative or positive CIA anti-HCV if the S/Co ratio is <3.0 or ≥20.0, respectively. To confirm HCV exposure, samples with an S/Co ratio between 3.0 and 19.9 should be followed up with RIBA unless PCR testing has been performed and the result is positive. Samples with an S/Co ratio ≥20.0 or positive RIBA results should be further tested by RT-PCR to determine HCV viremia status.


2019 ◽  
Vol 28 (4) ◽  
pp. 375-9
Author(s):  
Aida Lydia ◽  
Anindia Larasati ◽  
Rino Alvani Gani ◽  
Ikhwan Rinaldi

BACKGROUND The risk of hepatitis C virus (HCV) infection is increasing in patients under routine hemodialysis, but only some patients progress to liver fibrosis. This study was aimed to identify the prevalence of significant liver fibrosis in routine hemodialysis patients with hepatitis C infection as well as factors associated with liver fibrosis. METHODS This cross-sectional study was conducted in three tertiary general hospitals (Cipto Mangunkusumo Hospital, Persahabatan Hospital, and Fatmawati Hospital) in Jakarta, Indonesia, among hemodialysis patients infected with HCV. Total sampling was used from May to September 2017 in hemodialysis unit of all hospitals. Sex, age, time at first diagnosis of HCV, duration of HCV infection, duration of hemodialysis, AST level, hepatitis B virus coinfection and diabetes mellitus were analyzed in association with significant liver fibrosis. Liver fibrosis was assessed using transient elastography and considered significant if the value was ≥7.1 kPa. Chi-square, Mann–Whitney U, and Fisher’s exact tests were used. Risk model was analyzed with logistic regression. RESULTS Of the 133 hemodialysis patients infected with HCV, 71.4% of the subjects had significant liver fibrosis. In the risk model, male gender (odds ratio [OR] = 3.92; 95% confidence interval [CI] = 1.74–8.84; p < 0.001) and diabetes mellitus (DM) (OR = 2.85; 95% CI = 1.03–7.88; p = 0.043) were associated with significant liver fibrosis. CONCLUSIONS The prevalence of significant liver fibrosis in routine hemodialysis patients with hepatitis C infection was high. Male and DM were associated with significant liver fibrosis.


2020 ◽  
Vol 7 (7) ◽  
Author(s):  
Hyun-seok Kim ◽  
Rosalia Guerrero ◽  
Shane W Reader ◽  
Maria Daheri ◽  
Maya Balakrishnan ◽  
...  

Abstract A community outreach hepatitis C virus (HCV) infection screening program provided low yield of detecting HCV-infected patients, linking them to our hepatology clinic for treatment. Our data underscore that most of the yield was related to addiction centers and birth cohort; these groups should be targeted by future interventions.


2017 ◽  
Vol 158 (16) ◽  
pp. 603-611
Author(s):  
Krisztina Hagymási ◽  
Anna Egresi ◽  
Gabriella Lengyel

Abstract: The importance of chronic hepatitis C infection is significant. 3% of the World’s population is infected. There is at least one extrahepatic manifestation in 50% of HCV patients, which makes the prognosis and mortality worse. The pathomechanisms included are cryoglobulin production, immunmechanisms, and direct viral effects. The authors summarize the main extrahepatic manifestations, as well as treatment possibilities. The aim is to draw attention to this colourful infection in order to improve the recognition in the era of the new effective direct antiviral agents. Orv. Hetil., 2017, 158(16), 603–612.


Author(s):  
Abdulhadi I Bima ◽  
Amanda J Hooper ◽  
Frank M van Bockxmeer ◽  
John R Burnett

Familial hypercholesterolaemia (FH) is a common genetic disorder characterized by high plasma low-density lipoprotein (LDL)-cholesterol and premature coronary artery disease. Many factors, such as illness, high-dose statin therapy or a strict vegan diet can cause hypobetalipoproteinaemia (HBL). The more common secondary causes of HBL in the hospital setting include cachexia, intestinal malabsorption, malnutrition, severe liver disease and hyperthyroidism. We report a case of HBL in a 43-year-old man with previously demonstrated marked hypercholesterolaemia who attended a lipid disorders clinic for FH cascade screening. Surprisingly, a lipid profile taken at that time showed low plasma LDL-cholesterol and apolipoprotein B concentrations of 1.6 mmol/L and 0.61 g/L, respectively. He was not on lipid-lowering therapy. DNA sequencing showed that he was heterozygous for the LDLR gene mutation (C677R) present in other affected family members. Of interest, his serum transaminases were increased by ∼3-fold and hepatitis serology and genotyping confirmed a diagnosis of hepatitis C virus (HCV) infection. In summary, we describe a case of HBL secondary to chronic HCV infection in a patient with FH, confirmed by mutational analysis.


2020 ◽  
Author(s):  
James A. NDAKO ◽  
Akinyomade O Owolabi ◽  
Joseph A. Olisa ◽  
Jeremiah A. Akinwumi ◽  
Victor T. Dojumo ◽  
...  

Abstract Background: Hepatitis C virus (HCV) infection and type 2 diabetes mellitus (T2DM) are two major public health problems associated with increasing complications and mortality rates worldwide. The objective of this study to evaluate the prevalence of hepatitis C virus (HCV) infection in diabetic patients and to investigate the influence of several epidemiological and clinical factors on HCV infection. Method: A total number of one hundred and eighty diabetic patients were recruited for this study. Consented subjects made up of 71(39.4%) males and 109(60.56%) females were recruited for the study. While one-Hundred (100) Non-Diabetics (Controls) were recruited for this study. Structured questionnaires were administered to the consented participants to obtain relevant data. Sera samples were assayed for antibodies to HCV using an enzyme linked immunosorbent assay [Inteco Diagnostic Limited]. ELISA technique.Result: Overall prevalence of HCV infection among diabetes patients assayed was 13.3%. Out of which 8(11.3%) was obtained from the male subjects compared to 16 (14.7%) seropositivity recorded for the female subjects (P = 0.511; P > 0.05). Considering age distribution, Subjects aged 41-50 years recorded, 9 (22.5%) positivity (P= 0.238; P>0.05).Considering educational status of subjects screened, 22 (14.9%) positivity was rescored among subjects who have attained tertiary status of education.( P = 0.574;P>0.05).Risk factors considered showed that, 7 (18.9%) seropositive subject were alcoholic consumers(P value = 0.2621;P>0.05) while 5 (8.9%) recorded history of sharing sharp objects P= 0.2427;P>0.05).Conclusion: Our study shows a slightly higher prevalence of hepatitis C infection in type 2 diabetics. This call for urgent routine screening exercise among diabetic patients for HCV infection. This study also emphasizes the need for public enlightenment on the association between HCV infection and T2DM, to avert possible complications among diabetic patients.


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