scholarly journals Hepatitis C viral infection is associated with fibrillary glomerulonephritis and immunotactoid glomerulopathy.

1998 ◽  
Vol 9 (12) ◽  
pp. 2244-2252
Author(s):  
G S Markowitz ◽  
J T Cheng ◽  
R B Colvin ◽  
W M Trebbin ◽  
V D D'Agati
Keyword(s):  
Hepatitis C ◽  
Glomerular Disease ◽  
Hcv Infection ◽  
Not Given ◽  
Fibrillary Glomerulonephritis ◽  
Persistent Proteinuria ◽  
Immunotactoid Glomerulopathy ◽  
Membranous Glomerulopathy ◽  
Cryoglobulinemic Glomerulonephritis

The most common form of glomerular disease seen in association with hepatitis C virus (HCV) infection is membranoproliferative glomerulonephritis, with or without associated cryoglobulinemia. This study examines four cases of fibrillary glomerulonephritis and two cases of immunotactoid glomerulopathy in association with HCV infection. Findings at presentation included proteinuria, renal insufficiency, and hematuria. Renal biopsy revealed a membranoproliferative pattern of glomerular disease in five cases, and a membranous glomerulopathy with mesangial proliferative features in one. On immunofluorescence, all cases stained with IgG and C3. Electron microscopy revealed fibrils of the expected diameter, 16 to 28 nm in fibrillary glomerulonephritis and 33 to 45 nm in immunotactoid glomerulopathy. In only one case were cryoglobulins detected (at low titer and on only one of three assays). Antiviral therapy was not given in any of the six cases. Outcomes were mixed, with progression to renal failure occurring in two patients and persistent proteinuria with stable or improved renal function in three. Follow-up is not available on the sixth case. Both fibrillary glomerulonephritis and immunotactoid glomerulopathy have features that overlap with cryoglobulinemic glomerulonephritis. The relatedness of these three entities in a subset of patients with HCV infection suggests a common pathogenic mechanism of glomerular deposition of organized deposits.

scholarly journals Chronic Hepatitis C Virus Infection After Treatment for Pediatric Malignancy

Blood ◽  
1997 ◽  
Vol 90 (3) ◽  
pp. 1315-1320 ◽  
Author(s):  
Simone Cesaro ◽  
Maria Grazia Petris ◽  
Flavio Rossetti ◽  
Riccardo Cusinato ◽  
Corrado Pipan ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Liver Disease ◽  
Hepatitis C ◽  
Virus Infection ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Hcv Infection ◽  
Pediatric Malignancy ◽  
Infection Markers

Abstract Sera of 658 patients who had completed treatment for pediatric malignancy were analyzed by a second-generation enzyme-linked immunosorbent assay and recombinant immunoblot assay test to assess the prevalence of hepatitis C virus (HCV)-seropositivity. All HCV-seropositive patients underwent detailed clinical, laboratory, virologic, and histologic study to analyze the course of HCV infection. One hundred seventeen of the 658 patients (17.8%) were positive for HCV infection markers. Among the 117 anti-HCV+ patients, 41 (35%) were also positive for markers of hepatitis B virus infection with or without delta virus infection markers, 91 (77.8%) had previously received blood product transfusions, and 25 (21.4%) showed a normal alanine aminotransferase (ALT) level during the last 5-year follow-up (11 of them never had abnormal ALT levels). The remaining 92 patients showed ALT levels higher than the upper limit of normal range. Eighty-one of 117 (70%) anti-HCV+ patients were HCV-RNA+, with genotype 1b being present in most patients (54%). In univariate analysis, no risk factor for chronic liver disease was statistically significant. In this study, the prevalence of HCV infection was high in patients who were treated for a childhood malignancy. In about 20% of anti-HCV+ patients, routes other than blood transfusions are to be considered in the epidemiology of HCV infection. After a 14-year median follow-up, chronic liver disease of anti-HCV+ positive patients did not show progression to liver failure.

scholarly journals Evidence of hepatitis in patients receiving transfusions of blood components containing antibody to hepatitis C

Blood ◽  
1993 ◽  
Vol 82 (3) ◽  
pp. 1000-1005 ◽  
Author(s):  
SK Aoki ◽  
PV Holland ◽  
LP Fernando ◽  
IK Kuramoto ◽  
S Anderson ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Hcv Infection ◽  
Hcv Rna ◽  
Blood Components ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Immunoblot Assay ◽  
Polymerase Chain ◽  
Hepatitis C Virus Antibody

Abstract When hepatitis C virus antibody (anti-HCV) enzyme immunoassay (EIA1) testing became available in 1990, we tested samples from previously transfused blood units, traced the recipients of reactive units, and evaluated the recipients for HCV infection during the 12 months after transfusion. Ten of 42 recipients of EIA1-reactive blood were anti-HCV reactive on follow-up by EIA1 and 12 were reactive by a second- generation assay (EIA2). Reverse transcriptase-polymerase chain reaction (RT-PCR) detected HCV RNA in 5 seronegative recipients. In all, 17 of 42 recipients (40%) of EIA1-reactive blood had evidence of HCV infection. In comparison, 54 surgery patients, who received either no transfusion or autologous EIA1-nonreactive blood, remained EIA1 nonreactive and RT-PCR negative for 1 year; 1 patient (1.8%) became EIA2 reactive (P < or = .01). Of the recipients of anti-HVC reactive blood transfusions (reactive by both EIA1 and a supplemental 4-antigen strip immunoblot assay [RIBA2]), 14 (93%) of the recipients had evidence of HCV infection compared with only 3 of 27 recipients (11%) of EIA1-reactive, RIBA2-nonreactive blood (P < or = .01). Thus, blood components reactive for anti-HCV EIA1 may have transmitted HCV up to 40% of the time, but blood components found reactive by both EIA1 and RIBA2 may transmit HCV with a frequency of greater than 90%.

scholarly journals Evidence of hepatitis in patients receiving transfusions of blood components containing antibody to hepatitis C

Blood ◽  
1993 ◽  
Vol 82 (3) ◽  
pp. 1000-1005
Author(s):  
SK Aoki ◽  
PV Holland ◽  
LP Fernando ◽  
IK Kuramoto ◽  
S Anderson ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Hcv Infection ◽  
Hcv Rna ◽  
Blood Components ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Immunoblot Assay ◽  
Polymerase Chain ◽  
Hepatitis C Virus Antibody

When hepatitis C virus antibody (anti-HCV) enzyme immunoassay (EIA1) testing became available in 1990, we tested samples from previously transfused blood units, traced the recipients of reactive units, and evaluated the recipients for HCV infection during the 12 months after transfusion. Ten of 42 recipients of EIA1-reactive blood were anti-HCV reactive on follow-up by EIA1 and 12 were reactive by a second- generation assay (EIA2). Reverse transcriptase-polymerase chain reaction (RT-PCR) detected HCV RNA in 5 seronegative recipients. In all, 17 of 42 recipients (40%) of EIA1-reactive blood had evidence of HCV infection. In comparison, 54 surgery patients, who received either no transfusion or autologous EIA1-nonreactive blood, remained EIA1 nonreactive and RT-PCR negative for 1 year; 1 patient (1.8%) became EIA2 reactive (P < or = .01). Of the recipients of anti-HVC reactive blood transfusions (reactive by both EIA1 and a supplemental 4-antigen strip immunoblot assay [RIBA2]), 14 (93%) of the recipients had evidence of HCV infection compared with only 3 of 27 recipients (11%) of EIA1-reactive, RIBA2-nonreactive blood (P < or = .01). Thus, blood components reactive for anti-HCV EIA1 may have transmitted HCV up to 40% of the time, but blood components found reactive by both EIA1 and RIBA2 may transmit HCV with a frequency of greater than 90%.

Evaluation of a specialty hepatitis C virus telephone pharmacy service

2021 ◽  
Author(s):  
Ashley A Sabourin ◽  
Kaleigh K Fisher-Grant ◽  
Adam R Saulles ◽  
Rima A Mohammad
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Pharmacy Service ◽  
Hcv Infection ◽  
Pharmacy Services ◽  
Specialty Pharmacy ◽  
Clinically Significant ◽  
Direct Acting ◽  
The Impact

Abstract Purpose Direct-acting antivirals (DAAs) used to treat hepatitis C virus (HCV) infection are associated with significant drug-drug interactions (DDIs). Pharmacists are well positioned to identify and mitigate these DDIs. Data to guide assessment of the impact of HCV specialty pharmacy services on identifying and addressing DDIs with DAAs are lacking. The overall purpose of the study described here was to determine the incidence and severity of DDIs identified by specialty pharmacists among patients treated with DAAs prior to and 1 month into therapy. Methods An observational, retrospective study was conducted to evaluate the impact of specialty pharmacy services in mitigating DDIs associated with use of DAAs. Adult patients with HCV infection (n = 200) who received DAAs and were enrolled with a specialty pharmacy service over a 1-year period were included. Endpoints included number, severity, and type of DDIs and DDIs per patient at baseline and 1 month into therapy, pharmacists’ interventions, and safety and clinical outcomes. Results Fifty-nine percent of patients had at least 1 DDI. A total of 170 DDIs were identified (137 at baseline and 33 at 1-month follow-up), and the mean number of DDIs per patient significantly decreased from baseline to 1-month follow-up (from 1.38 to 0.16, P &lt; 0.0001). The rate of “potentially clinically significant” or “critical” interactions was significantly lower at 1-month follow-up vs baseline assessment (69.6% vs 81.7%, P &lt; 0.0001). The most commonly identified DDIs involved acid suppressive medications (49.6% and 66.6% of DDIs at baseline and follow-up assessment, respectively) and cardiovascular medications (26.2% and 21.2%, respectively). Total number of DDI interventions was 131, with an acceptance rate of 85%. Most common intervention was patient education and monitoring. Conclusion Approximately 60% of patients had DDIs with DAAs. Implementing HCV specialty pharmacy services significantly decreased DDIs while maintaining SVR12.

Clinical efficacy of Direct Acting Antivirals (DAAs) for Treatment of Recurrent Hepatitis C Virus infection After Liver Transplantation

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Saleh Mohamed Ahmed Ismail ◽  
Osama Aboelfotoh El Sayed ◽  
Mohamed Mohamed Bahaa El-Din ◽  
Wael Ahmed Yousry ◽  
Maha Mohsen Kamal El-Din ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Treatment Failure ◽  
Hcv Infection ◽  
Post Transplantation ◽  
Recurrent Hepatitis ◽  
History Of ◽  
Recurrent Hepatitis C ◽  
Hcc Recurrence

Abstract BACKGROUND & AIMS Recurrent hepatitis C virus (HCV) infection of transplanted liver allografts is universal in patients with detectable HCV viremia at the time of transplantation. Directacting antiviral (DAA) therapy has been adopted as the standard of care for recurrent HCV infection in the post-transplant setting. However, there are insufficient data regarding its efficacy in liver transplant (LT) recipients with a history of hepatocellular carcinoma (HCC), and the risk of HCC recurrence after DAA therapy is unknown. In this study, we aimed to demonstrate predictors of DAA treatment failure and HCC recurrence in LT recipients. METHODS A total of 106 LT recipients given DAAs for recurrent HCV infection from 2015 to 2019 were identified (68 with and 38 without HCC). Descriptive statistics and logistic regression models were used to estimate the multivariate odds ratios and respective 95% confidence intervals for predictors of treatment failure and HCC recurrence. RESULTS Six patients (6%) experienced DAA therapy failure and 100 (94%) had a sustained virologic response at follow-up week 12 (SVR12). A high alanine transaminase level &gt;35 U/L at treatment week 4 was a significant predictor of treatment failure. DAA failure at follow-up week 12 was significantly associated with post-transplantation HCC recurrence, (odds ratio, 10.6 [95% confidence interval, 1.0-121.6]; P = .05). CONCLUSIONS DAAs are effective and safe in the treatment of recurrent HCV infection in LT recipients with history of HCC. Lack of SVR12 is a predictor of post-transplantation HCC recurrence.

scholarly journals Hepatitis C virus infection among teenagers in an endemic township in Taiwan: epidemiological and clinical follow-up studies

2001 ◽  
Vol 127 (3) ◽  
pp. 485-492 ◽  
Author(s):  
J. F. HUANG ◽  
S. N. LU ◽  
P. Y. CHUE ◽  
C. M. LEE ◽  
M. L. YU ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hcv Infection ◽  
Hcv Rna ◽  
Follow Up Studies ◽  
Screening Study ◽  
Long Term Follow Up ◽  
Chronic Hcv Infection ◽  
Chronic Hcv

The aim of the study was to elucidate the epidemiological features of Hepatitis C virus (HCV) infection among teenagers in an endemic area by conducting a mass screening study. We also investigated the clinical outcome of the anti-HCV-positive subjects by conducting subsequent short-term and long-term follow-up studies. All 2837 students of two junior middle schools in Tzukuan, aged 13–16 years, were invited to be screened for anti-HCV, HBsAg, AST and ALT in October 1995. A total of 2726 (96%) students responded. Anti-HCV, HCV RNA and aminotransferase levels were evaluated among anti-HCV-positive students 1 month and 30 months later, respectively. A total of 38 (1·4%; M/F = 22/16) participants were anti-HCV-positive. The anti-HCV-positive students had higher rates of exposures to transfusion, anti-HCV-positive families and surgery. The prevalence (2·8%) of the 7 maritime villages was markedly higher than that (0·7%) of the other 8 villages (P < 0·001). Subsequent follow-up studies demonstrated that there might be 5 cases of acute or recent HCV infection, and 6 cases who had recovered from chronic HCV infection.

Clinico-Pathological Characteristics of B-Cell Non Hodgkins Lymphomas Associated with Hepatitis C Virus ANRS HC13 LYMPHO-C Observational Study.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1927-1927
Author(s):  
Caroline Besson ◽  
Danielle Canioni ◽  
Catherine Settegrana ◽  
Henda Driss ◽  
Laurent Alric ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Observational Study ◽  
B Cell ◽  
Conflicts Of Interest ◽  
Antiviral Treatment ◽  
B Cell Lymphoma ◽  
Hcv Infection ◽  
Immune Stimulation

Abstract Abstract 1927 Poster Board I-950 Introduction: Hepatitis C virus (HCV) associated B-cell non-Hodgkin's lymphoma (B-NHL) is a rare entity that constitutes a model to study chronic immune stimulation related lymphomas. They are known to be preferentially Marginal Zone Lymphomas (MZL) and Diffuse Large B Cell Lymphoma (DLBCL) subtypes. Conflicting results are reported on the association between Follicular Lymphoma (FL) and HCV. In order to study the physiopathology of HCV-related B-NHL, we pursue a multicentric observational study in France. We present here the clinicopathological characteristics of the patients included. Patients and methods: Adult patients with a history of HCV associated B-NHL are included in the study. HCV infection is defined by a positive viral load at diagnosis of NHL. Patients with HIV infection are excluded from the study. Each patient is followed every 6 months during 5 years. At each follow-up, a blood sample is withdrawn allowing ancillary studies. Data collection concerns clinical presentation, treatment and evolution of NHL and HCV infection. Pathological and cytological materials are centralized in order to allow their review and a concerted analysis by a group of expert hematopathologists, haematologists and immunologists. Results: The data of the 54 consecutive patients included between november 2006 and april 2009 in 20 french centers are presented. Median age is 63 years (ranging from 39 to 87 years). There is a predominance of men: sex ratio (m/f) is 1.45 (32/22). Included women are older than men (p<0.01), median age being 71 among women and 60 years among men. HCV genotypic distribution does not differ from expected in a HCV infected population in France: 1: 51% (25/49), 2: 29% (14/49), 3: 8% (4/49), 4: 12% (6/49), 5 missing data. Transmission risk groups, known in 50% (27/54) of cases, are transfusion (18), drug abuse (5), endemic origin (2), and tattoo/acupuncture (2). Two patients are co-infected with HBV. Twenty-four patients out of 42 tested (57%) had positive cryoglobulinemia at diagnosis of NHL. This proportion did not differ with gender nor with genotype. Fifteen cases were included at diagnosis of B-NHL. The 39 other cases were included during follow-up of NHL. The median interval between NHL diagnosis and last follow-up is 15 months (range 0-13y). The histological subtype distribution is DLBCL 39% (21), MZL 35% (19), FL 13% (7), CLL 6% (3). Remarkably, there is a continuum between MZL and DLBCL, 6 cases with ongoing transformation. Four cases could not be classified due to small disease infiltration or lack of material. We confirm the link between cryoglobulinemia and MZL, 12+ out of 17 tested, 6+/12 in DLBCL versus 2+/5 in FL and 1+/2 in CLL. Nodal involvement is infrequent (5 out of 21 cases of DLBCL, 2/19 MZL, 4/7 FL). Extranodal involvements predominated in spleen (15 including 8 MZL), lung (6), digestive tract (4), liver (3), heart (1), skin (6) and bone marrow (4). The efficiency of antiviral treatment is confirmed in 5 cases with MZL, and remarkably, was followed by a good response in one case with FL. However, most patients in this observational study received treatment with Rituximab (R) either alone (5 cases with MZL), or combined with chemotherapy (including 15 cases with DLBCL and 4 with FL) or with antiviral treatment. This was associated with good clinical responses in most cases and low toxicity. Indeed, only 5 patients died during follow-up – two from disease progression - a 85 y man and a 40 y woman with liver DLBCL who was resistant to 3 lines of R-chemotherapy. The other patients died of sepsis (2), and cardiac ischemia (1). Conclusions: This study strengthens the heterogeneity of HCV-related lymphomas. The observation of cases with MZL and, remarkably, of one case with FL responding to antiviral treatment suggests that they are both linked to chronic immune stimulation. Therefore, the concept of antigen-driven lymphomagenesis seems more heterogeneous than initially anticipated: it could involve a T independent response in MZL, and a T dependent response in FL. The ongoing pathophysiological study will improve further understanding of the mechanisms by which antigen-driven lymphoproliferation arise. Disclosures: No relevant conflicts of interest to declare.

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