Diagnosis of hepatitis C

Lok, Anna S.; Gunaratnam, Naresh T.

doi:10.1002/hep.510260709

Cited by 77 publications

(72 citation statements)

References 103 publications

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“…Even with the improvement in the sensitivity of second generation tests (anti-HCV EIA-2), falsepositives (negative RIBA-2) are claimed, in other series, to still occur in 40% of the donors tested by EIA (15,85). The low number of falsepositive cases among our donors perhaps reflects the fact that we only evaluated anti-HCV in individuals with an EIA-2 ratio >3 (highly positive).…”

Section: Discussionmentioning

confidence: 98%

A clinical, epidemological, laboratorial, histological and ultrasonographical evaluation of anti-HCV EIA-2 positive blood donors

Gonçales

Stucchi

Pavan

et al. 2000

Rev. Inst. Med. trop. S. Paulo

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SUMMARYBetween 1992 and 1997, 790 blood donors with anti-HCV EIA-2 strongly reagent (relationship between the sample optical density/cut-off > 3) detected at the blood bank serological screening, were evaluated in ambulatory environment. They were all negative for Chagas disease, syphilis, hepatitis B (HBsAg) and AIDS. Blood samples were collected at the first ambulatorial evaluation, for hemogram, biochemical tests and new serological tests for HCV (anti-HCV EIA-2). In blood samples of 226 repeatedly reagent anti-HCV EIA-2 blood donors, supplementary "immunoblot" test for HCV (RIBA-2) was used. In 209 donors, the presence of HCV-RNA was investigated by the PCR test. The abdominal ultrasonography was realized in 366 donors. In 269 patients liver biopsy was performed for the histopathological study. The follow-up of blood donors showed that 95.6% were repeatedly EIA-2 reagent, 94% were symptomless and denied any hepatitis history, with only 2% mentioning previous jaundice. In 47% of this population at least one risk factor has been detected for the HCV transmission, the use of intravenous drugs being the main one (27.8%). Blood transfusion was the second factor for HCV transmission (27.2%). Hepatomegaly was detected in 54% of the cases. Splenomegaly and signs of portal hypertension have seldom been found in the physical examination, indicating a low degree of hepatic compromising in HCV. Abdominal ultrasound showed alterations in 65% of the subjects, being the steatosis the most frequent (50%). In 83.5% of the donors submitted to the liver biopsy, the histopathological exam showed the presence of chronic hepatitis, usually classified as active (89%) with mild or moderate grade in most of the cases (99.5%). The histopathological exam of the liver was normal in 1.5% of blood donors. The RIBA-2 test and the HCV-RNA investigation by PCR were positive in respectively 91.6 and 75% of the anti-HCV EIA-2 reagent donors. The HCV-RNA research was positive in 82% of the RIBA-2 positive subjects, in 37.5% of the indeterminate RIBA-2 donors and in 9% of the negative RIBA-2 donors. Chronic hepatitis has also been observed in 50% of the histopathological exams of the anti-HCV EIA-2 reagent donors which were indeterminate RIBA-2. Among 18 blood donors with minimal changes histopathological exam 11 (61%) were HCV-RNA positive. Our blood donors anti-HCV reagent generally had clinical, laboratorial and histopathological features observed in patients with chronic HCV hepatitis and a high proportion could be identified in interviews and medical evaluation realized in blood blanks. Generally, these HCV infected donors are identified and discharged only by the serological tests results.

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Section: Discussionmentioning

confidence: 98%

A clinical, epidemological, laboratorial, histological and ultrasonographical evaluation of anti-HCV EIA-2 positive blood donors

Gonçales

Stucchi

Pavan

et al. 2000

Rev. Inst. Med. trop. S. Paulo

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“…Only 1 (17%) of 6 RIBA-3 positive samples were PCR positive, compared with 50-86% reported in HCV-infected populations in the United States. 4,19 Variant HCV, chance, false-positive RIBA-3 results or improper serum storage are possible explanations for this poor correlation. 19,20 Specimens collection and transportation followed standardized procedures according to the study protocol.…”

Section: Discussionmentioning

confidence: 99%

“…4,19 Variant HCV, chance, false-positive RIBA-3 results or improper serum storage are possible explanations for this poor correlation. 19,20 Specimens collection and transportation followed standardized procedures according to the study protocol. Sera were frozen under proper conditions in our repository and minimal manipulation has occurred.…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence of hepatitis C virus in the general population of northwest Tanzania.

Tess

Levin²,

Brubaker³

et al. 2000

The American Journal of Tropical Medicine and Hygiene

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Abstract. Sera from 516 participants enrolled in a population-based cross-sectional study in northwest Tanzania were tested for antibodies to hepatitis C virus (HCV). The mean age of study subjects was 29 years (range ϭ 16-49 years); 43% were men, 6% reported a history of blood transfusion, and 4% were infected with human immunodeficiency virus-1 (HIV-1). Although 53 of 516 sera (10.3%, 95% confidence interval [CI] ϭ 7.8-13.2%) were repeatedly reactive by a third-generation enzyme immunoassay (EIA-3), only 6 of the 53 were positive when tested with a thirdgeneration recombinant immunoblot assay (confirmed HCV seroprevalence ϭ 1.2%, 95% CI ϭ 0.4-2.5%). The positive predictive value of the HCV EIA-3 in this population was 18.8% (95% CI ϭ 7.0-36.4%). False positivity was not correlated with EIA-3 optical density values, age, sex, infection with HIV-1, or a history of blood transfusion, but it was marginally associated with increased serum IgG levels. We conclude that the prevalence of HCV is low in this region and that the HCV EIA-3 has a higher false-positivity rate in this population than has been reported among U.S. blood donors.Hepatitis C virus (HCV) is the major etiologic agent of post-transfusional hepatitis worldwide 1 and may also be an important cause of community acquired non-A, non-B hepatitis in certain parts of Africa. 2,3 Infection with HCV is usually asymptomatic, but may result in chronic hepatitis with progression to cirrhosis and hepatocellular carcinoma. 4,5 Assays for the detection of antibodies against HCV proteins were developed soon after the viral genome was cloned in 1989. 6 An enzyme immunoassay (EIA) represented an important advance in reducing HCV transmission through blood transfusion. Supplemental tests for detecting antibodies to HCV, such as the recombinant immunoblot assay (RIBA), have been developed to confirm reactivity detected by the EIA. 7 Studies of volunteer blood donors and general populations have shown considerable geographic variation in HCV seroprevalence:8 0.5-1.5% in western Europe, northern Europe, North America, and Australia; 1.5-2.5% in Japan and the Mediterranean region; and as high as 14% in Egypt. In sub-Saharan Africa, data on the prevalence of HCV are limited and the extent of HCV infection remains unknown in most countries. In this study, we estimated the seroprevalence of HCV in a population-based cross-sectional study in northwest Tanzania. METHODSDuring 1989 and 1990, a population-based study was conducted to estimate the prevalence of human immunodeficiency virus (HIV) in northwest Tanzania. The protocol for this study was approved by the appropriate review committees of the Tanzanian Ministry of Health and the National Cancer Institute. The study methods have been described elsewhere. 9 Briefly, the target population consisted of people living in rural, peri-urban (mainly subsistence farmers and their families), and urban areas (commercial workers). Subjects 15-49 years of age were randomly selected from household rosters supplied by the local governmen...

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“…Further testing to confirm the diagnosis of HCV infection is, strictly speaking, unnecessary. 13,14 However, HCV-RNA testing is recommended if treatment is contemplated. Patient 2 had a normal ALT level and no identifiable risk factor.…”

Section: Discussionmentioning

confidence: 99%

Current practice patterns of primary care physicians in the management of patients with hepatitis C

et al. 1999

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Diagnosis of hepatitis C

Cited by 77 publications

References 103 publications

A clinical, epidemological, laboratorial, histological and ultrasonographical evaluation of anti-HCV EIA-2 positive blood donors

A clinical, epidemological, laboratorial, histological and ultrasonographical evaluation of anti-HCV EIA-2 positive blood donors

Seroprevalence of hepatitis C virus in the general population of northwest Tanzania.

Current practice patterns of primary care physicians in the management of patients with hepatitis C

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