The diagnosis of hepatitis C viral infection

2014 ◽  
Vol 155 (26) ◽  
pp. 1019-1023
Author(s):  
Judit Gervain
Keyword(s):  
Hepatitis C ◽  
Nucleic Acid ◽  
Viral Infection ◽  
Structural Changes ◽  
Viral Infections ◽  
Transient Elastography ◽  
Viral Nucleic Acid ◽  
Length Of Treatment ◽  
Subtype B

The successful therapy of hepatitis C viral infection requires that the illness is diagnosed before the development of structural changes of the liver. Testing is stepwise consisting of screening, diagnosis, and anti-viral therapy follow-up. For these steps there are different biochemical, serological, histological and molecular biological methods available. For screening, alanine aminotransferase and anti-HCV tests are used. The diagnosis of infection is confirmed using real-time polymerase chain reaction of the viral nucleic acid. Before initiation of the therapy liver biopsy is recommended to determine the level of structural changes in the liver. Alternatively, transient elastography or blood biomarkers may be also used for this purpose. Differential diagnosis should exclude the co-existence of other viral infections and chronic hepatitis due to other origin, with special attention to the presence of autoantibodies. The outcome of the antiviral therapy and the length of treatment are mainly determined by the viral genotype. In Hungary, most patients are infected with genotype 1, subtype b. The polymorphism type that occurs in the single nucleotide located next to the interleukin 28B region in chromosome 19 and the viral polymorphism type Q80K for infection with HCV 1a serve as predictive therapeutic markers. The follow-up of therapy is based on the quantitative determination of viral nucleic acid according to national and international protocols and should use the same method and laboratory throughout the treatment of an individual patient. Orv. Hetil., 2014, 155(26), 1019–1023.

The impact of direct-acting antivirals on liver fibrosis in Egyptian hepatitis C virus patients: a single center experience

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Nadia Abdelaaty Abdelkader ◽  
Amira Mahmoud AlBalakosy ◽  
Ahmed Fouad Helmy Sherief ◽  
Mohamed Soliman Gado
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Treatment Unit ◽  
Non Invasive ◽  
One Year ◽  
The Impact

Abstract Background Hepatitis C virus (HCV) infection affects approximately 170 million people worldwide, causing liver cirrhosis and hepatocellular carcinoma (HCC) and leading to liver transplantation and ultimately death. Accurate evaluation of liver fibrosis in patients with chronic liver diseases is crucial, as liver fibrosis is important in order to make therapeutic decisions, determine prognosis of liver disease and to follow-up disease progression. Multiple non-invasive methods have been used successfully in the prediction of fibrosis; however, early changes in noninvasive biomarkers of hepatic fibrosis under effective antiviral therapy are widely unknown. The aim of this study is to evaluate changes of transient elastography values as well as FIB-4 and AST to platelet ratio index (APRI) in patients treated with DAAs. Objectives The aim beyond this study is to evaluate the changes in liver stiffness in hepatitis C Egyptian patients before and at least one year after treatment with DAAs using transient elastography and non-invasive liver fibrosis indices as FIB-4 and APRI scores. Patients and methods The present study was conducted on 100 patients with chronic hepatitis C patients attended to Ain Shams University Hospitals, Viral hepatitis treatment unit between October 2017 and December 2018, who were followed-up during treatment and after treatment for at least one year (retrospective and prospective study). Total number of cases during the study period was 117 patients. 17 patients were excluded from the study due to missed follow-up. Eventually, 100 patients were enrolled in the study fulfilling the inclusion criteria. Results The mean age of our patients is 47.9 years with Male predominance (52 males and 48 females). There was a significant improvement of, platelets counts, ALT and AST levels, which in turn cause significant improvement in FIB-4 and APRI scores. There was a significant improvement of liver stiffness after end of treatment, regardless of the DAA regimen used, as evidenced by Fibroscan. Conclusion Fibrosis regression –assessed by non-invasive markers of fibrosis is achievable upon removal of the causative agent.

Viral Infection

2013 ◽  
Author(s):  
Jason A. Castellanos ◽  
Nipun B. Merchant
Keyword(s):  
Electron Microscopy ◽  
Viral Infection ◽  
Viral Infections ◽  
Hospital Staff ◽  
Herpes Viruses ◽  
Viral Nucleic Acid ◽  
Viral Antigens ◽  
Animal Bites ◽  
Virus Size ◽  
Size And Structure

Although surgeons are seldom required to treat viral infections, viral infection exposure should still be a topic of concern to surgeons, because infection can cause illness in patients after surgery, and can spread to the hospital staff. This review discusses the prevention of transmission of HIV and hepatitis B and C viruses and the management of exposure to these viruses. A discussion of virus size and structure is presented, and six methods for detection are reviewed: serologic testing, isolation of virus, histologic examination, detection of viral antigens, detection of viral nucleic acid, and electron microscopy. Also discussed are viral infections that are of interest to surgeons, including HIV, hepatitis, herpes viruses, and viral infections from animal bites. This review contains 5 figures, 10 tables, 1 diagnostic HIV algorithm, and 137 references.

scholarly journals Risk of Viral Infection in Patients Using Either Angiotensin-converting Enzyme Inhibitors or Angiotensin Receptor Blockers: A Nationwide Population-based Propensity Score Matching Study

2020 ◽  
Vol 71 (10) ◽  
pp. 2695-2701
Author(s):  
Shih-Yi Lin ◽  
Shu-Woei Ju ◽  
Cheng-Li Lin ◽  
Cheng-Chieh Lin ◽  
Wu-Huei Hsu ◽  
...  
Keyword(s):  
Propensity Score ◽  
Angiotensin Converting Enzyme ◽  
Viral Infection ◽  
Propensity Score Matching ◽  
Lower Risk ◽  
Viral Infections ◽  
Incidence Rates ◽  
Converting Enzyme ◽  
Angiotensin Receptor

Abstract Background We hypothesized that renin–angiotensin system (RAS) blockers have systemic protective effects beyond the respiratory tract and could reduce the risk of viral infections. Methods We used the National Health Insurance Research Database and identified 2 study cohorts: the angiotensin receptor blocker (ARB) cohort and angiotensin-converting enzyme inhibitor (ACEI) cohort. Propensity score matching was applied at a 1:1 ratio by all associated variables to select 2 independent control cohorts for the ARB and ACEI cohorts. A Cox proportional hazards model was applied to assess the end outcome of viral infection. Results The number of ARB and ACEI users was 20 207 and 18 029, respectively. The median age of ARB users and nonusers was 53.7 and 53.8 years, respectively. The median follow-up duration of ARB users and nonusers was 7.96 and 7.08 years; the median follow-up duration of ACEI users and nonusers was 8.70 and 8.98 years, respectively. The incidence rates of viral infections in ARB users and nonusers were 4.95 and 8.59 per 1000 person-years, respectively, and ARB users had a lower risk of viral infection than nonusers (adjusted hazard ratio [aHR], 0.53 [95% confidence interval {CI}, .48–.58]). The incidence rates of viral infections in ACEI users and nonusers were 6.10 per 1000 person-years and 7.72 per 1000 person-years, respectively, and ACEI users had a lower risk of viral infection than nonusers (aHR, 0.81 [95% CI, .74–.88]). Conclusions Hypertensive patients using either ARBs or ACEIs exhibit a lower risk of viral infection than nonusers.

scholarly journals The applicability of non-invasive methods for assessing liver fibrosis in hemodialysis patients with chronic hepatitis C

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242601
Author(s):  
Jia-Jung Lee ◽  
Yu-Ju Wei ◽  
Ming-Yen Lin ◽  
Sheng-Wen Niu ◽  
Po-Yao Hsu ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Diagnostic Accuracy ◽  
Chronic Hepatitis C ◽  
Transient Elastography ◽  
Hemodialysis Patients ◽  
Accurate Assessment ◽  
Non Invasive

Background The accurate assessment of liver fibrosis among hemodialysis patients with chronic hepatitis C (CHC) is important for both treatment and for follow up strategies. Applying the non-invasive methods in general population with viral hepatitis have been successful but the applicability of the aminotransferase/platelet ratio index (APRI) or the fibrosis-4 index (FIB-4) in hemodialysis patients need further evaluation. Materials and methods We conducted a prospective, multi-center, uremic cohort to verify the applicability of APRI and FIB-4 in identifying liver fibrosis by reference with the standard transient elastography (TE) measures. Results There were 116 CHC cases with valid TE were enrolled in our analysis. 46 cases (39.6%) were classified as F1, 35 cases (30.2%) as F2, 11 cases (9.5%) as F3, and 24 cases (20.7%) as F4, respectively. The traditional APRI and FIB-4 criteria did not correctly identify liver fibrosis. The optimal cut-off value of APRI was 0.28 and of FIB-4 was 1.91 to best excluding liver cirrhosis with AUC of 76% and 77%, respectively. The subgroup analysis showed that female CHC hemodialysis patients had better diagnostic accuracy with 74.1% by APRI. And CHC hemodialysis patients without hypertension had better diagnostic accuracy with 78.6% by FIB-4. Conclusions This study confirmed the traditional category level of APRI and FIB-4 were unable to identify liver fibrosis of CHC hemodialysis patients. With the adjusted cut-off value, APRI and FIB-4 still showed suboptimal diagnostic accuracy. Our results suggest the necessary of TE measures for liver fibrosis in the CHC uremic population.

scholarly journals Enhanced Expression of Autoantigens During SARS-CoV-2 Viral Infection

2021 ◽  
Vol 12 ◽  
Author(s):  
Narjes Saheb Sharif-Askari ◽  
Fatemeh Saheb Sharif-Askari ◽  
Samrein B. M. Ahmed ◽  
Suad Hannawi ◽  
Rifat Hamoudi ◽  
...  
Keyword(s):  
Viral Infection ◽  
Whole Blood ◽  
In Silico ◽  
Mononuclear Cells ◽  
Viral Infections ◽  
Peripheral Blood Mononuclear ◽  
Protein Levels ◽  
Enhanced Expression

Immune homeostasis is disturbed during severe viral infections, which can lead to loss of tolerance to self-peptides and result in short- or long-term autoimmunity. Using publicly available transcriptomic datasets, we conducted an in-silico analyses to evaluate the expression levels of 52 autoantigens, known to be associated with 24 autoimmune diseases, during SAR-CoV-2 infection. Seven autoantigens (MPO, PRTN3, PADI4, IFIH1, TRIM21, PTPRN2, and TSHR) were upregulated in whole blood samples. MPO and TSHR were overexpressed in both lung autopsies and whole blood tissue and were associated with more severe COVID-19. Neutrophil activation derived autoantigens (MPO, PRTN3, and PADI4) were prominently increased in blood of both SARS-CoV-1 and SARS-CoV-2 viral infections, while TSHR and PTPRN2 autoantigens were specifically increased in SARS-CoV-2. Using single-cell dataset from peripheral blood mononuclear cells (PBMCs), we observed an upregulation of MPO, PRTN3, and PADI4 autoantigens within the low-density neutrophil subset. To validate our in-silico analysis, we measured plasma protein levels of two autoantigens, MPO and PRTN3, in severe and asymptomatic COVID-19. The protein levels of these two autoantigens were significantly upregulated in more severe COVID-19 infections. In conclusion, the immunopathology and severity of COVID-19 could result in transient autoimmune activation. Longitudinal follow-up studies of confirmed cases of COVID-19 could determine the enduring effects of viral infection including development of autoimmune disease.

scholarly journals Prognostic Value of Transient Elastography in Human Immunodeficiency Virus-Infected Patients With Chronic Hepatitis C

2016 ◽  
Vol 3 (4) ◽  
Author(s):  
Leire Pérez-Latorre ◽  
Antonio Rivero-Juárez ◽  
Víctor Hontañón ◽  
Cristina Díez ◽  
Francisca Cuenca ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Prognostic Value ◽  
Transient Elastography ◽  
Sustained Viral Response ◽  
Liver Stiffness ◽  
Receiver Operating Characteristic Curves ◽  
Study Population

Abstract Background Our objective was to study the prognostic value of liver stiffness (LS) in HIV-infected patients with chronic hepatitis C (CHC). Methods We analyzed HIV-infected patients with compensated CHC and at least 1 determination of LS. The primary outcome was the occurrence of liver-related events (LRE), namely, decompensation or hepatocellular carcinoma, whichever occurred first. We selected patients without sustained viral response (SVR) or end-of-treatment response (ETR) during follow-up and allocated them to an estimation cohort (EC) and a validation cohort (VC). Results The study population comprised 1292 patients. After a median follow-up of 5.8 years, 90 patients experienced LRE and 73 died. In the subgroup of 957 patients without SVR or ETR, the area under the receiver operating characteristic curves (AUROCs) (95% confidence interval [CI]) of LS for prediction of LRE in the EC (n = 634) and the VC (n = 323) were 0.87 and 0.88, respectively. The best cutoff value of LS to rule out LRE in the EC was 12 kPa, with a negative predictive value of 98.3% in the EC and 98.2% in the VC. Per each 1 kPa and 5 kPa increase above 12 kPa, the hazard ratio of LRE (taking into account death as a competing risk) was 1.07 (95% CI, 1.05–1.08) and 1.38 (95% CI, 1.31–1.46), respectively. Conclusions Liver stiffness is very accurate for predicting LRE in coinfected patients. Patients with an LS <12 kPa had a 98% probability of not developing LRE after a median follow-up of almost 6 years. Above the 12-kPa cutoff, the hazard of LRE increases proportionally with LS.

MO1015EARLY URINARY SYSTEM COMPLICATIONS IN CHILDREN WITH HEMATOPOETIC STEM CELL TRANSPLANTATION

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Anar Gurbanov ◽  
Bora Gülhan ◽  
Barış Kuşkonmaz ◽  
Fatma Visal Okur ◽  
Duygu Uçkan Çetinkaya ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Viral Infection ◽  
Cell Transplantation ◽  
Viral Infections ◽  
Classification Systems ◽  
Urinary System ◽  
Malignant Diseases ◽  
The Mean

Abstract Background and Aims Urinary system complications after hematopoietic stem cell transplantation (HSCT) cause severe morbidity and mortality. The aim of the study is to investigate the incidence and risk factors of urinary system complications in patients who had HSCT during their childhood. Method Patients who had HSCT between January 2010-2019 with a minimum follow-up period of 6 months were included in the study. Data regarding urinary system complications were collected from the medical records of the patients. pRIFLE and KDIGO classification systems were used for the definition of acute kidney injury (AKI). Results 167 patients (108 males and 59 females) with allogeneic (n=165) and autologous (n=2) HSCT were investigated for renal complications. In cohort, HSCT was performed in 41 patients (%24.6) secondary to malignant diseases and in 126 patients secondary to non-malignant diseases. Hemorrhagic cystitis (HC) developed in 28 patients (16.8%) after HSCT. The mean age of the patients with and without HC was 14.6±5.6 years and 10.5±6 years, respectively (p=0.044). Among patients with HC, 17 had concomitant viral infection. Presence of viral infection, gender, disease group, history conditioning regime, total body irradiation, acute graft-versus-host disease and veno-occlusive disease (VOD) did not have any effect on the development of HC in logistic regression analysis. In cohort, 126 patients (75.4%) developed AKI according to KDIGO classification (stage 1; 55 patients, stage 2; 36 patients, stage 3; 35 patients). The mean period of development of AKI after HSCT was 34±22 days. The risk of AKI (according to KDIGO) was higher in patients who had HSCT secondary to malignant diseases and/or who developed viral infections after HSCT (p=0.034 and p=0.013, respectively). Among patients, 71 patients (%42.5) developed AKI according to pRIFLE classification. The risk of AKI (according to pRIFLE) was higher in patients who had HSCT secondary to malignant diseases, who developed viral infections and/or who developed VOD during follow-up (p=0.043, p=0.001 and p=0.006, respectively). One patient developed thrombotic microangiopathy after HSCT. None of the patients had nephrotic syndrome during follow-up period. Conclusion Patients who had HSCT secondary to malignant disease, viral infections and/or VOD had higher risk of AKI and should be closely monitored.

scholarly journals Investigation of the drug «Cycloferon» influence on the morbidity of acute respiratory viral infections and flu and condition of local immunity in children of different age groups

2006 ◽  
Vol 5 (2) ◽  
pp. 119-126
Author(s):  
Ye. I. Kondratieva ◽  
L. A. Matveeva ◽  
Ye. Yu. Tyuteva ◽  
N. A. Ryzhakova ◽  
A. A. Terentieva ◽  
...  
Keyword(s):  
Viral Infection ◽  
Viral Infections ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Local Immunity ◽  
Respiratory Viral Infection ◽  
Upper Respiratory ◽  
Respiratory Viral Infections ◽  
Acute Respiratory Viral Infection

The aim of the research was the investigation of prophylactic using the drug «Cycloferon». Influence of Cycloferon on acute respiratory viral infection and flu and on their clinical manifestations as well as on local immunity condition was assessed. We examined 124 children aged from 4 to 18 years. It was revealed that duration of acute respiratory viral infections as well as flu decreased and local immunity of the upper respiratory ways increased considerably in children taking Cycloferon. The abovementioned changes were observed both just after the treatment and in the follow-up period.

scholarly journals Pitfalls of viral load testing

2010 ◽  
Vol 31 (3) ◽  
pp. 119
Author(s):  
Geoff Higgins
Keyword(s):  
Viral Load ◽  
Hepatitis C ◽  
Nucleic Acid ◽  
Hepatitis B ◽  
Medical Practice ◽  
Quantitative Measurement ◽  
Load Testing ◽  
Viral Nucleic Acid ◽  
Viral Load Testing ◽  
Hepatitis C Viruses

Viral load testing is the quantitative measurement of viral nucleic acid in body fluids or tissues. In medical practice, viral load assays are commonly performed for HIV, Hepatitis B and Hepatitis C viruses. These assays are funded under the Medicare Benefits Schedule (MBS) system (Item numbers 69378/81/82, 69482/3 and 69488 respectively).

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