Document 6535379

Virul
(
hepatitis:
co6/077
clinical
205
uspects
( CO6/079 1
1
IRON STATUS OF PATIENTS
HEPATITIS C
AN AUTOMATED SAMPLE PREPARATION
FOR HCV PCR
WITH CHRONIC
V.T. Ivashkin*. E. Lukina. M. Maievskaja*.
E. Svsoieva. C. Pavlov*. N.D. Khoroshko.
A. Levina,
G.A. Frank.
Moscow Medical Academy*, National Research Center for
Haematology, Moscow, Russia.
In spite of the ever-increasing body of knowledge on the subject
of iron, infection and neoplasia, many aspects remain unclear
and in some cases controversial.
Recent studies suggest that
increased hepatic iron may impair the response to interferon
therapy in patients (pts) with chronic hepatitis C and there is a
significant correlation between hepatic iron grade and serum
ferritin. The goal of this study was to investigate the iron status of 24 untreated noncirrhotic pts with serum HCV RNA
positive chronic hepatitis C. All the pts (age 23-67 years) had
low histological activity index (Knodell score = 3-8) and serum
aminotransferases
<I,53 normal levels. We investigated the
following serum indices of iron metabolism: iron concentration
(SI), total iron binding capacity, transferrin iron saturation (TIS),
ferritin, transferrin. Increased SI, TIS and ferritin levels were
found in 42%, 42% and 67% pts, respectively. Low transferrin
level was found in 53% pts. In summary, we found that a high
proportion of patients with chronic hepatitis C with low
histological and clinical activity had mild to moderate iron
overload. Further studies may provide insights whether the iron
chelators may increase the response to interferon therapy.
HCV
INFECTION
EPIDEMIOLOGICAL
METHOD
IN
FIAEMODIALYSED
AND CLINICAL ASPECTS
PATIENTS
-
M.Indot’ . MZalewska . U.Bem?. A.Gladvsz'
.D.Zwoliliskaz
Dpt.of Infectious Diseases’ , Dpt of Nephrolo&,
Medical University,
Wrociaw, Poland
A’iM: HCV infection is an important problem in I-ID unitsThe aim of
the study was to evaluate epidemiology and course of HCV infection in
young, haemodialysed patients.
MATERIAL AND METHODS: 18 patients, age range 9 - 41, x=17,9,
M 8,F 10 were evaluated. Anti-HCV antibodies were tested by screening
enzyme immunoassay ( Abbott Diagnostic HCV EIA, 3’d gen.). AntiHCV antibodies were sought by
Liatek HCV 3” gen.( Organon
Teknika). HCV RNA was detected by a standarized HCV RNA PCR
assay ( Amplicor HCV, Roche Diagnostic System)
Amplicor HCV
Monitor (Troche Diagnostic System) was used to monitor viral load, the
results were expressed in HCV RNA copies/ml.
RESULTS: HCV infection was diagnosed in 11 ( 6 1 %) patients. , the
average duration of haemodialysis in infected patients was 5 years, in
HCV negative only 3 months.The other risk factors of HCV infection
(blood transfusion,surgery,
IVDU) were analysed - there was no
correlations beteween HCV infection and these factors. In two cases
HCV infection was diagnosed by PCR anti-HCV were negative. None of
the HCV infected patients have the clinical manifestation of hepatitis,
the mild activity of ALT was observed in 4 cases only. HCV viremia was
significantly
lower than in control group ( HCV infected. nonhaemodialysed patients ) 3 18,6 copies/ml YS 1011.2 copies/ml @<O,OOl).
In 3 patients in LIATEK we found antibodies anti-cl, C2, EZMSl, NS3.
NS4, NSS, viremia in these patients was extremally low - <lo copies/ml.
CONCiUSIONS:
1) The duration of HD is the most important risk
factor of HCV infection.2) The course of HCV infection in HD patients is
asymptomatic, HCV viremia is very low.
JR. Hildebrandt. *R. Herron, A. Starron. Z. Li, E. Reitz. T.
Niemiec. M. Fairchild, K.C. Youna, G. Baechler. *A.
Decker, *K. Loaan. l*W. Rev. Roche Molecular
Systems, Alameda, California, USA; *Branchburg, NJ,
USA; l * Roche Diagnostics Instrument Center Tegimenta, Rotkreuz, Switzerland
An instrument is being developed to accomplish fully
automated specimen processing for isolation of Hepatitis C
Virus (HCV) RNA. The specimen preparation method is
based on hybridization of viral target with oligonucleotide
probe followed by magnetic particle capture of the probeRNA complex. The processed specimen is compatible with
the AMPLICOR@ HCV, COBAS AMPLICORTM HCV,
AMPLICOR HCV MONITORTM, and COBAS AMPLICOR
HCV MONITORTM Tests. A patient correlation study showed
good correlation between the automated method and the
AMPLICOR HCV MONITORTM Test with manual specimerl
preparation. Linearity and precision over the dynamic range
of the AMPLICOR HCV MONITORTM Test will be presented.
The automated specimen preparation method increased the
sensitivity of the COBAS AMPLICORTM HCV Test to better
than 100 copies/ml without detectable sample inhibition. Full
automation of specimen preparation in conjunction with
amplification and detection on the COBAS AMPLICORTM
analyzer will insure further incorporation of PCR in the
routine diagnostic laboratory.
Elevated Alanine Aminotransferase (ALT) in Blood Donors: An
Assessment of the Main Causes and Its Relationship to the Development
of Hepatitis.
E L. Goncales Jr.. R. S. B. Snack. PM. 0. Pamrordanou. M. H. P. PavanM. C.
Chmvm. C. A. F. Escanhmia, ‘N. S. L. Goncdes.
“J. R. R. Pmho.
Faculdade de Ci&ias Medicas, Univasidade Estadual de Campinas, S&o Paula Brazil,
*Hemccmtm
Univasidade
Estadual de Camhas:
**Serviw de Virolonia, lmtituto
Adolf0 Lutz, Secretaria Estadul de Sairde, Sio Paula, SP, Ekil.
determination of aminotranferases levels is very useful in the dignoses
of hepatopathies. In recent years, an elevated serum AL.T levels in blood
donors has been associated with an increase risk of post-transfusion
hepatitis The purpose of the study was to assesses the factors associated
with elevated ALT levels in a cohort of voluntary blood donors and evaluates
the relationship between rmsed ALT levels and the development of HCV
infection.
Materials and Methods: 116 volunteer blood donors with elevated ALT at
the time of their first donation were studied. All of the donors were
questioned about previous hepatopathies, exposure to hepatitis, exposure to
chemicals, use of medication or drugs, sexual behaviour, contact with blood
or secretions and their intake of alcohol. Every three months the serum levels
of AST, XT, alkaline phosphatase, a glutanil transpeptidase, cholesterol,
triglyceride and glycemia are assessed over a two years follow-up. The serum
thyroid hormone levels as well as the presence of auto-antibodies were
measured. Abdominal ultrasound was performed in patients with persistently
elevated ALT or AST levels. A needle biopsy of liver using the Menghine
technique was performed in nine individuals. Anti-HCV antibody levels were
assayed at the first clinical evaluation and during the follow-up period (about
six months later)
Rerulrs: None of donors listed positive for hepatitis B and hepatits C
markers during the follow-up. 10 1I1 16 (87%) continued to exhibit elevated
ALT levels during the follow-up. Obesity and alcoholism were the principal
factors related to elevated ALT levels in 91/101 (90%) of the donors. 3001
(2,9%) were exposed daily to hepatotoxic industrial solvents and paints.
Hiperlipidemia (l/101), hypothyoidism (l/101), diabetes mellitus (l/101)
also were associated with increased ALT levels. In 31101 (2,9%) the liver
biopsy showed reactive hepatitis. Only one donor out of 116 (0.9%) had non
A-G viral hepatitis and elevated ALT levels during the follow-up period
Conclusion: The determination of aminotransferases levels isn’t helpful1 in
preventing post-transfusion hepatitis and must be discontinued in Brazil.
The