Chronic Hepatitis C Virus Infections in Leukemia Survivors: Prevalence, Viral Load, and Severity of Liver Disease

Abstract The natural history of chronic hepatitis C (HCV) infections in long-term leukemia survivors has not been well characterized. We studied the prevalence of HCV infections, measured HCV RNA levels, and evaluated the severity of liver disease in patients with leukemia who achieved long-term remissions after intensive chemotherapy or bone marrow transplantation (BMT). HCV antibody tests were performed by the enzyme-linked immunosorbent assay (ELISA) and positive tests confirmed by the recombinant immunoblot assay (RIBA). HCV RNA levels were measured by the branched DNA (bDNA) assay. Seventy-five leukemia survivors with 25 or more blood donor exposures were identified. Nine (12%) were anti-HCV positive. All were infected before 1992 when second generation HCV screening tests were implemented. Mean HCV RNA levels were 10.3 ×106 eq/mL versus 3.2 × 106 eq/mL (P = .056) in a control group of 20 anti-HCV positive immunocompetent individuals of comparable age who were infected twice as long (17.8 ± 6.5 years v 9.0 ± 4.4 years in leukemia survivors, P = .001). Liver biopsies were performed on six of the nine anti-HCV positive leukemia survivors. All showed at least moderate portal inflammation and half had evidence of bridging fibrosis. We conclude that viral loads in anti-HCV positive leukemia survivors are markedly higher than in immunocompetent controls. Our results suggest that long-term leukemia survivors with chronic HCV may have more rapidly progressive liver disease than has been previously recognized.

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Chronic Hepatitis C Virus Infections in Leukemia Survivors: Prevalence, Viral Load, and Severity of Liver Disease

Blood ◽

10.1182/blood.v93.11.3672.411k04_3672_3677 ◽

1999 ◽

Vol 93 (11) ◽

pp. 3672-3677 ◽

Cited By ~ 1

Author(s):

Ian M. Paul ◽

Jeffrey Sanders ◽

Francesca Ruggiero ◽

Thomas Andrews ◽

David Ungar ◽

...

Keyword(s):

Chronic Hepatitis ◽

Liver Disease ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Screening Tests ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Hcv Rna ◽

Rna Levels

The natural history of chronic hepatitis C (HCV) infections in long-term leukemia survivors has not been well characterized. We studied the prevalence of HCV infections, measured HCV RNA levels, and evaluated the severity of liver disease in patients with leukemia who achieved long-term remissions after intensive chemotherapy or bone marrow transplantation (BMT). HCV antibody tests were performed by the enzyme-linked immunosorbent assay (ELISA) and positive tests confirmed by the recombinant immunoblot assay (RIBA). HCV RNA levels were measured by the branched DNA (bDNA) assay. Seventy-five leukemia survivors with 25 or more blood donor exposures were identified. Nine (12%) were anti-HCV positive. All were infected before 1992 when second generation HCV screening tests were implemented. Mean HCV RNA levels were 10.3 ×106 eq/mL versus 3.2 × 106 eq/mL (P = .056) in a control group of 20 anti-HCV positive immunocompetent individuals of comparable age who were infected twice as long (17.8 ± 6.5 years v 9.0 ± 4.4 years in leukemia survivors, P = .001). Liver biopsies were performed on six of the nine anti-HCV positive leukemia survivors. All showed at least moderate portal inflammation and half had evidence of bridging fibrosis. We conclude that viral loads in anti-HCV positive leukemia survivors are markedly higher than in immunocompetent controls. Our results suggest that long-term leukemia survivors with chronic HCV may have more rapidly progressive liver disease than has been previously recognized.

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Use of antiviral therapy in patients with chronic hepatitis C

Open Medicine ◽

10.1515/med-2015-0032 ◽

2015 ◽

Vol 10 (1) ◽

Cited By ~ 1

Author(s):

Natalia Dragomiretskaya ◽

Anna Izha ◽

Nikolay Kalinichenko ◽

Mirosława Szark-Eckardt ◽

Mariusz Klimczyk ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Antiviral Therapy ◽

Chronic Hepatitis C ◽

Adverse Outcomes ◽

Hcv Infection ◽

Blood Analysis ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Hcv Rna

AbstractIntroduction: The presence of background HCV infection cannot be overestimated in view of the prevalence of chronic hepatitis C and the risk of adverse outcomes of this disease. Purpose of this study was to evaluate the effectiveness of the combined use of antiviral therapy (Roferon + Vero-Ribavirin) and resort factors in patients with chronic hepatitis C in the phase of replication. Material and methods: We observed 48 patients with chronic hepatitis C; the minimum level of activity of the process defined the phase of replication. Markers of HCV infection were determined by enzyme linked immunosorbent assay (ELISA) (a-HCV and HCV-Ig M). HCV RNA was determined twice by the polymerase chain reaction (PCR). Genotyping of hepatitis C virus was performed. Biochemical blood analysis and the study of HCV infection markers were carried out four times. Results of therapy were assessed immediately after the end of the resort (spa) treatment, then at 3, 6 and 12 months after starting treatment. At 12 months after starting treatment, all the observed patients had persistent clinical and biochemical remission. Elimination of the virus from the blood was noted in 56% of the control group and 74% of patients in the study group. Conclusions: For patients with moderately active HCV, the replication phase was characterized by asthenic-vegetative syndrome (100% of patients) with severe depression (22.92%), pain (77.08%) and dyspeptic syndrome (33.33%), moderate hypertransferaseemia (100%), slightly pronounced cholestasis (33% of patients), and signs of mesenchymal- inflammatory response.

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CLINICAL PROFILE AND THE CIRCULATING GENOTYPES OF HEPATITIS C VIRUS IN A TERTIARY CARE HOSPITAL IN WEST BENGAL

10.36106/gjra/6811683 ◽

2021 ◽

pp. 165-167

Author(s):

Kumkum Sarkar ◽

Rupak Chatterjee ◽

Sumanta Sinha ◽

Netai Pramanik

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C Virus ◽

Liver Disease ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Hcv Rna ◽

Care Hospital ◽

Patient Department

Background and objectives- Hepatitis C virus (HCV) infection is a major cause of chronic liver disease worldwide, with majority of the patients being asymptomatic and when they present to clinicians, they have already advanced liver disease in form of cirrhosis or hepatocellular carcinoma. Data from developing countries on this evolving global health problem are sparse. Hence this study was planned with the aim to determine the HCV genotypes prevalant in patients attending a tertiary care hospital with their clinical prole. Materials and Methods- Detailed history taking and clinical examination were done of consecutive 30 patients who attended out-patient department or admitted at in- patient department of Tropical Medicine with chronic hepatitis C. Laboratory investigations like LFT, viral serology (HBsAg, AntiHCV, HIV), prothrombin time, ultrasonography of upper abdomen, HCV- RNA Quantative assay with genotyping were done. Data were collected and then analysed using standard statistical methods. Result- Of proposed 30 sample size, complete data could be collected of 28 patients and accordingly, analysis was done. Of the 28 HCV seroreactive individuals, majority (20) were males. The mode of transmission was unknown in 19 patients, blood transfusion in 5 patients who were thalassemic and hemodialysis in remaining 4 patients. Most of the patients (18/28) were asymptomatic even if their viral load was high. Most common presenting symptom was dyspepsia. LFT showed signicant transaminitis in 50% of the patients. Of the 28 seroreactive patients, 15 (53.57%) were HCV RNA positive based on RT-PCR. HCV rNA was below detectable level in 13 patients. HCV genotype 3 was the predominant genotype found in 11 individuals followed by genotype 1 found in 3 and genotype 2 was seen in one individual. Conclusion- Community screening specially among high risk individuals is needed for early diagnosis and prompt treatment of chronic hepatitis C to prevent its several complications and also to prevent community spread.

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Chronic hepatitis C in Austria, 1992–2006: genotype distribution and demographic factors

Eurosurveillance ◽

10.2807/ese.15.08.19492-en ◽

2010 ◽

Vol 15 (8) ◽

Cited By ~ 8

Author(s):

A Maieron ◽

S Metz-Gercek ◽

F Hackl ◽

C Luger ◽

A Ziachehabi ◽

...

Keyword(s):

Risk Factors ◽

Chronic Hepatitis ◽

Liver Disease ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Risk Groups ◽

Hcv Rna ◽

Age Difference ◽

Genotype Distribution ◽

Upper Austria

Chronic hepatitis C is a leading cause of end-stage liver disease and, with a worldwide prevalence of up to 3%, is a pandemic infectious disease. Austria, like most western European countries can be considered as a low prevalence country. This analysis aimed to assess the distribution of hepatitis C virus (HCV) genotypes in patients with chronic HCV infection in Upper Austria. Between September 1992 and December 2006, we identified 1,318 consecutive patients who tested positive for HCV RNA. Genotyping was routinely performed in 1,239 of the 1,318 patients, and in a subgroup of 617 patients data on the source of transmission were collected. Additionally we obtained data on liver histology and body mass index in a subsample of 273 of the 617 patients. Hepatitis C genotypes 1, 2, 3, 4, 6 and co-infections were found in 80.4%, 4.5%, 12.3%, 2.7%, 0.1% and 0.2% of the patients, respectively. There was a highly significant age difference in relation to gender at the time of diagnosis of chronic hepatitis C, with women being older than men (men: 45.0 years; women: 49.3 years; p<0.0001). The number of new cases of chronic hepatitis C decreased substantially over the last decade, but although risk factors for obtaining HCV are well established, we did not find a decrease in the age of first diagnosis. Besides consistent screening in defined risk groups it is important to raise awareness for risk factors for HCV acquisition and liver disease progression.

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