Ocorrência de hepatites não-anão-B em unidade de hemodiálise

Takahashi

Gaspar

et al. 1992

Nephron

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Sixteen of 110 hemodialysis (HD) patients fulfilling criteria of non-A, non B hepatitis (NANBH), i.e. alanine aminotransferase (ALT) > 50 U/ml in the absence of both serologic markers for acute HBV and HAV infections and clinical evidence of another cause of hepatitis, were tested for the presence of antibodies against hepatitis C virus (anti-HCV) by enzyme immunoassay (Ortho, Diagnostics). All (100%) were anti-HCV-positive. There were 5 patients with a monophasic (M) rise pattern (1 or 2 ALT rises), and 11 cases demonstrated a polyphasic (P) rise elevation pattern (more than 2). The mean ALT value of the M group was 202.3 ± 209 U/ml and that of the P group was 116.6 ± 39.1 U/ml. The patients received a mean of 19.1 ± 16.2 units of packed red cells during the follow-up period (69.9 months). Only 1 patient received no blood transfusion. Six patients had a past HBV infection and 3 became HIV-infected in the course of this study. The high rate of infection of hemodialysis patients with hepatitis C virus in our setting points to the need for improved control measures.

Section: Introductionmentioning

confidence: 99%

Hepatitis C Virus in Chronic Hemodialysis Patients with Non-A, Non-B Hepatitis

Takahashi

Gaspar

et al. 1992

Nephron

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Early appearance and biphasic kinetics of IgG antibody against hepatitis C virus protein C100-3

Soares

Schatzmayr

et al. 1992

Med Microbiol Immunol

Antibody to recombinant hepatitis C virus (HCV) protein C100 (anti-C100) was measured for a period of 6 months by enzyme immunoassay in nine prospectively followed non A-nonB (NANBH) cases which occurred after cardiac surgery at a hospital in Rio de Janeiro (Brazil). At least seven cases were infected with HCV; four of these developed chronic hepatitis as shown in liver biopsy at the 6th month after transfusion. The first elevation of alanine aminotransferase (ALT) occurred between 15 and 45 days after transfusion and ALT values remained elevated for 45 days in resolving hepatitis, whereas in chronic cases fluctuation levels were observed until the end of the study. Anti-C100 appeared after 15 to 30 days, decreased after some weeks, and rose finally to high concentrations except in one resolving case where it disappeared. We conclude that both in acute and chronic hepatitis C an early antibody response occurs which may, however, be undetectable in some cases. After several months all chronic and some resolving cases develop a second stronger response.

Antibodies against non-structural c100/3 and structural core antigen of hepatitis C virus (HCV) in hemodialysis patients

Rev. Inst. Med. trop. S. Paulo

Takahashi

Vanderborght³

et al. 1993

Two groups of patients undergoing hemodialysis (HD) maintenance were evaluated for their antibody response to non-structural c100/3 protein and structural core protein of hepatitis C virus (HCV). Forty-six patients (Group 1) never presented liver abnormalities during HD treatment, while 52 patients (Group 2) had either current or prior liver enzyme elevations. Prevalence rates of 32.6% and 41.3% were found for anti-c100/3 and anti-HCV core antibodies, respectively, in patients with silent infections (Group 1). The rate of anti-c100/3 in patients of Group 2 was 71.15% and reached 86.5% for anti-HCV core antibodies. The recognition of anti-c100/3 and anti-core antibodies was significantly higher in Group 2 than in Group 1. A line immunoassay composed of structural and non-structural peptides was used as a confirmation assay. HBV infection, measured by the presence of anti-HBc antibodies, was observed in 39.8% of the patients. Six were HBsAg chronic carriers and 13 had naturally acquired anti-HBs antibodies. The duration of HD treatment was correlated with anti-HCV positivity. A high prevalence of 96.7% (Group 2) was found in patients who underwent more than 5 years of treatment. Our results suggest that anti-HCV core ELISA is more accurate for detecting HCV infection than anti-c100/3. Although the risk associated with the duration of HD treatment and blood transfusion was high, additional factors such as a significant non-transfusional spread of HCV seems to play a role as well. The identification of infective patients by more sensitive methods for HCV genome detection should help to control the transmission of HCV in the unit under study.