Late onset of severe thrombocytopenia during interferon treatment for chronic hepatitis C infection: Case report

Introduction. Thrombocytopenia is a common finding in chronic liver diseases and it is caused by different pathophysiological mechanisms. Immunologic thrombocytopenic purpura (ITP) in hepatitis C infection is a distinct clinical entity. Possible reasons for ITP in this case could be capabillity of HCV to induce autoimmune phenomena but also immunomodulatory effects of interferon that is used for HCV infection treatment. The specific laboratory parameters for ITP diagnosis during HCV infection have not been defined yet. Case Outline. A 37-year-old patient diagnosed with HCV infection was treated with PEG-interferon and Ribavirin during 24 weeks. The partial response was achieved after the therapy with reduction of viral replications. One month after therapy completion, the patient was hospitalized due to skin haemorrhagic syndrome and a serious degree of thrombocytopenia (2?109/l). The number and megakaryocyte morphology in bone marrow aspirate were normal. An assay of thrombocyte kinetics by radioactive marker (Indium 111) showed rapid thrombocyte destruction and their early seljuestration in the spleen. Conclusion. Results of assays about thrombocyte kinetics during HCV infection show enchanced thrombocyte destruction in the liver. Accordingly, the most important parameter for ITP diagnosis in HCV infection, in this case, was rapid thrombocyte destruction and their early sequestration in the spleen approved by Indium kinetics. Also, in support of ITP is the increment of thrombocyte number during therapy with intravenous immunoglobulins. Thrombocytopenia was developing during antiviral therapy and on indirect conclusion is that viral replication is not the reason for it.

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Treatment of acute hepatitis C infection with interferon-alfa 2b monotherapy prevents development of chronic HCV infection

Gastroenterology ◽

10.1016/s0016-5085(01)82820-1 ◽

2001 ◽

Vol 120 (5) ◽

pp. A567-A567 ◽

Cited By ~ 1

Author(s):

E JAECKEL ◽

M CORNBERG ◽

T SANTANTONIO ◽

J MAYER ◽

H WEDEMEYER ◽

...

Keyword(s):

Hepatitis C ◽

Acute Hepatitis ◽

Interferon Alfa ◽

Hcv Infection ◽

Acute Hepatitis C ◽

Hepatitis C Infection ◽

Chronic Hcv Infection ◽

Chronic Hcv

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Emergence of occult minority genotype 2b hepatitis C infection in an HIV-1-co-infected patient treated for genotype 5a HCV infection with 48 weeks of pegylated-interferon-α 2b and ribavirin

Journal of Clinical Virology ◽

10.1016/j.jcv.2007.05.010 ◽

2007 ◽

Vol 40 (1) ◽

pp. 60-63

Author(s):

A.J. Buckton ◽

R. Kulasegaram ◽

S.L. Ngui ◽

M. Fisher ◽

R. James ◽

...

Keyword(s):

Hepatitis C ◽

Infected Patient ◽

Pegylated Interferon ◽

Hcv Infection ◽

Interferon Α ◽

Hepatitis C Infection ◽

Hiv 1

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Fatigue, depression and chronic hepatitis C infection

Psychological Medicine ◽

10.1017/s0033291701004615 ◽

2002 ◽

Vol 32 (1) ◽

pp. 1-10 ◽

Cited By ~ 55

Author(s):

SIMON WESSELY ◽

CARMINE PARIANTE

Keyword(s):

Liver Disease ◽

Hepatitis C ◽

Hcv Infection ◽

Review Of The Literature ◽

Hepatitis C Infection ◽

Epidemiological Evidence ◽

Advanced Liver Disease ◽

Specialist Referral ◽

Lack Of Exercise ◽

The Moment

Background. We aimed to determine if an association exists between uncomplicated hepatitis C virus (HCV) infection and depression or fatigue.Method. A review of the literature was undertaken.Results. There is an association between HCV infection and either depression or fatigue in certain circumstances – those who are aware they are HCV positive, those with advanced liver disease and those seen in specialist referral centres. All these studies are subject to important biases. There are only a few studies in which knowledge of HCV status and assessment of fatigue or depression is independent. These studies do not suggest an association. There is no association between conventional markers of liver disease and depression or fatigue.Conclusions. Despite anecdotal evidence to the contrary, at the moment there is no evidence that HCV infection per se is associated with fatigue or depression, and there is a suggestion that it is not. The same risk factors that exist for fatigue in other physical illnesses, such as metabolic disorder, mood disorder, demographics and lack of exercise, certainly exist for HCV. Although there are elegant theoretical mechanisms, there is no compelling epidemiological evidence for an additional HCV specific fatigue or depression factor.

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HEPATITIS C INFECTION IN PATIENTS WITH PRIMARY HYPOGAMMAGLOBULINEMIA AFTER TREATMENT WITH CONTAMINATED IMMUNE GLOBULIN

PEDIATRICS ◽

10.1542/peds.98.2.351a ◽

1996 ◽

Vol 98 (2) ◽

pp. 351-351

Author(s):

Robert A. Wood

Keyword(s):

Hepatitis C ◽

Immune Globulin ◽

Hcv Infection ◽

High Rate ◽

Hepatitis C Infection ◽

Progressive Course

Patients with hypogammaglobulinemia had a high rate of HCV infection after treatment with contaminated immune globulin. These patients experienced a severe and rapidly progressive course with their HCV infection and responses to interferon were poor.

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Increased levels of circulating IL-10 in persons recovered from hepatitis C virus (HCV) infection compared with persons with active HCV infection

BMC Research Notes ◽

10.1186/s13104-020-05313-w ◽

2020 ◽

Vol 13 (1) ◽

Author(s):

Dorcas Ohui Owusu ◽

Richard Phillips ◽

Michael Owusu ◽

Fred Stephen Sarfo ◽

Margaret Frempong

Keyword(s):

Hepatitis C ◽

Spontaneous Recovery ◽

Predictive Marker ◽

Serum Levels ◽

Hcv Infection ◽

Tnf Alpha ◽

Hepatitis C Infection ◽

Ifn Gamma ◽

The Relationship

Abstract Objective Approximately 70% of all hepatitis C (HCV) infections develop chronic disease. Active or exacerbated chronic hepatitis C infection subsequently progress to liver disease. The role of T-cells secretions in achieving viral clearance is still not well understood. Thus, the current study was set to determine the relationship between the T cell cytokine profiles, biochemical parameters and persistent HCV infection or spontaneous recovery. Results Twenty-five percent (41/163) of the anti-HCV positive participants had recovered from HCV and had significantly higher concentration of IL-10 compared to those with active HCV infection (P < 0.012). Other circulating cytokines measured; IL-2, IFN gamma, TNF alpha, IL-5 and IL-17 were similar in both groups. Participants with active HCV infection had significantly higher aspartate transaminase (AST) (35 units) and alanine transaminase (46 units) compared to those in the recovered state (P < 0.001). Thus, serum levels of IL10 could be explored in larger prospective cohort study as a predictive marker of recovering from an active HCV infection.

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Housing Stability and Hepatitis C Infection for Young Adults Who Inject Drugs: Examining the Relationship of Consistent and Intermittent Housing Status on HCV Infection Risk

Journal of Urban Health ◽

10.1007/s11524-020-00445-7 ◽

2020 ◽

Vol 97 (6) ◽

pp. 831-844

Author(s):

Meghan D. Morris ◽

Irene H. Yen ◽

Steve Shiboski ◽

Jennifer L. Evans ◽

Kimberly Page

Keyword(s):

Hepatitis C ◽

Cox Regression ◽

Infection Risk ◽

Hcv Infection ◽

Hepatitis C Infection ◽

Housing Status ◽

Housing Stability ◽

Stable Housing ◽

Independent Association ◽

The Relationship

AbstractHousing status affects drug using behaviors, but less is known about the relationship between housing patterns and hepatitis C virus (HCV) infection. HCV-negative young people who inject drugs (PWID) were enrolled into a prospective cohort (2003–2019) with quarterly study visits. We used Cox regression to estimate the independent association of recent housing status (housed vs. unhoused, housing stability, and housing trajectory) on HCV incidence. Among 712 participants, 245 incident HCV infections occurred over 963.8 person-years (py) (cumulative incidence 24.4/100 py). An inverse relationship between time housed and HCV incidence was observed (always unhoused 45.0/100 py, 95% confidence interval (CI) 37.1, 54.5; variably housed 18.0/100 py, 95% CI 15.0, 21.3; and always housed 7.0/100 py, 95% CI 3.0, 17.3). In Cox regression models controlling for confounders, those unhoused versus housed at baseline had a 1.9-fold increased infection risk (95% CI 1.4, 2.6). Those always unhoused versus always housed had a 1.5 times greater risk of HCV (95% CI 1.0, 2.3), and those spending a portion of time in stable housing a lower risk (adjusted relative hazard 0.05, 95% CI 0.3, 0.9) with a similar trend for those being housed for less time. Young adult PWID experiencing both recent and chronic states of being unhoused are at elevated risk for HCV infection. Importantly for this group of PWID, our findings indicate that some frequency of residential housing significantly reduces HCV infection risk.

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293. Hepatitis C is now a Millennial Disease in Response to the Opioid Crisis: A Demographic Shift in Hepatitis C Infection

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.368 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S159-S159

Author(s):

Michelle Rose ◽

John Allen Myers ◽

Nicholas Ryan ◽

Alissa Prince ◽

Morgan Talbot ◽

...

Keyword(s):

Hepatitis C ◽

Baby Boomers ◽

Infected Individual ◽

The United States ◽

Hcv Infection ◽

Demographic Shift ◽

Hepatitis C Infection ◽

Opioid Crisis ◽

Chronic Hcv ◽

Over Time

Abstract Background Previous research has shown millennials represent the fastest growing generation for those infected with the hepatitis C virus (HCV). Millennials are also a key driver in the opioid crisis, particularly in states of the Appalachian region including Kentucky. Despite research demonstrating a change in prevalence from baby boomers (born 1945–1965) to millennials (born 1980–1995), large representative studies providing evidence of the magnitude of this demographic shift are lacking in the United States. Our objective was to assess trends of HCV infection since 2016 in a large healthcare system located in an area of high prevalence of opioid use and HCV infection. Methods All individuals were screened for HCV infection in 2016, 2017, and 2018 within Norton Healthcare per standard risk-based criteria (e.g., injection drug users, baby boomers, etc.) as recommended by CDC, except for pregnant women who were universally screened since 2016. We tested for demographic shifts over time using longitudinal and time series analyses techniques Results A total of 86,243 individuals were screened for HCV infection from 2016 to 2018. Of those, 2,615 (3.0%) individuals screened positive for chronic HCV. The average age of those infected significantly decreased by an average of 3.7 years annually (from 47.3 years in 2016 to 39.9 years in 2018, P < 0.001). We forecast a plateau near the age of 28 years will be observed in just over 7 years. In addition, the proportion of millennials increased over time (33.6% in 2016, 42.4% in 2017 and 51.4% in 2018, P < 0.001), while baby boomers significantly decreased over time (44.0% in 2016, 38.8% in 2017, and 29.3% in 2018, P < 0.001). Lastly, over time, those with chronic HCV were more likely to be male (increasing from 49.6% to 54.4%, P = 0.008) and Hispanic (increasing from 1.6% to 17.7%, P < 0.001) Conclusion Our results suggest that HCV infection has become a predominately millennial disease, skipping a generation. These results correlate with trends seen with the opioid epidemic, which is driven by millennials. We conclude that the opioid crisis has led to a drastic demographic shift, and currently the typical HCV-infected individual is a younger male. Without interventions, this trend will continue for over seven years, plateauing near the demarcation of millennials and generation Z Disclosures All authors: No reported disclosures.

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Hepatitis C infection among survivors of childhood cancer

Blood ◽

10.1182/blood.v95.10.3065 ◽

2000 ◽

Vol 95 (10) ◽

pp. 3065-3070 ◽

Cited By ~ 69

Author(s):

Donald K. Strickland ◽

Caroline A. Riely ◽

Christian C. Patrick ◽

Dana Jones-Wallace ◽

James M. Boyett ◽

...

Keyword(s):

Liver Disease ◽

Hepatitis C ◽

Liver Function ◽

Childhood Cancer ◽

Normal Liver ◽

Hcv Infection ◽

Hcv Rna ◽

Hepatitis C Infection ◽

Primary Malignancy ◽

Survivors Of Childhood Cancer

Abstract Preliminary reports have suggested that survivors of childhood cancer and aplastic anemia who are infected with the hepatitis C virus (HCV) have a low risk for progression to significant liver disease. Among our surviving patients who were transfused between 1961 and March 1992, 77 (6.6% of surviving patients tested thus far) have evidence of HCV infection, whereas 4 surviving patients who were transfused after March 1992 are HCV-infected. One patient chronically infected with HCV died of liver failure, and 2 patients died of hepatocellular carcinoma. To characterize the risk for these and other complications, 65 patients are enrolled in a longitudinal study of HCV infection, of whom 58 (89.2%) had circulating HCV RNA at the time of protocol enrollment, with genotypes 1A and 1B most commonly isolated. Most enrolled patients have few or no symptoms, carry out normal activities, and have normal liver function. To date, 35 patients have undergone liver biopsy for abnormal liver function since the diagnosis of primary malignancy; central pathology review shows 28 (80%) have chronic active hepatitis, 25 (71%) have fibrosis, and 3 (9%) have cirrhosis. These preliminary data suggest that though most survivors of childhood cancer who are infected with HCV are clinically well, some are at risk for clinically significant liver disease. Identification of other HCV-infected patients and prospective monitoring of this cohort are ongoing to determine the risk for, and to identify factors associated with the progression of, liver disease.

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