The presence of hepatitis C virus (HCV) antibody in human immunodeficiency virus-positive hemophilic men undergoing HCV "seroreversion"

Ragni, Margaret V.; Ndimbie, Oliver K.; Rice, Erin; Bontempo, Franklin A.; Nedjar, Sayah

doi:10.1182/blood.v82.3.1010.1010

Cited by 52 publications

(12 citation statements)

References 15 publications

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“…(ii) Conversely, in our experience, indeterminate RIBA3.0 patterns are more frequent in HCV-infected immunosuppressed patients than in HCV-infected immunocompetent patients (unpublished data). (iii) Similarly, seronegative chronic HCV infection is frequently observed in immunosuppressed patients and is exceptional in immunocompetent ones (3,8,18). Apparent seroconversions and seroreversions have even been observed parallel to fluctuations in the immune status of immunosuppressed patients (18).…”

Section: Discussionmentioning

confidence: 98%

“…(iii) Similarly, seronegative chronic HCV infection is frequently observed in immunosuppressed patients and is exceptional in immunocompetent ones (3,8,18). Apparent seroconversions and seroreversions have even been observed parallel to fluctuations in the immune status of immunosuppressed patients (18). The mechanism underlying indeterminate RIBA3.0 patterns in immunosuppressed patients with replicating HCV infection might be impairment of antibody production by B lymphocytes.…”

Section: Discussionmentioning

confidence: 99%

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Significance of indeterminate third-generation hepatitis C virus recombinant immunoblot assay

et al. 1996

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Indeterminate hepatitis C virus (HCV) third-generation recombinant immunoblot assay (RIBA3.0; Ortho Diagnostic Systems) patterns were arbitrarily defined by the manufacturer as the detection of only one antibody out of the four that were sought, namely, c100 (NS4 encoded), c22 (core encoded), c33c (NS3 encoded), and NS5 (NS5 encoded). The aims of the present study were (i) to determine the prevalence of indeterminate RIBA3.0 patterns in patients consecutively tested for anti-HCV antibodies in a university hospital; (ii) to evaluate the significance of these patterns in terms of viral replication, liver disease, and risk factors for HCV; and (iii) to get an insight into the mechanism underlying this peculiar immune response. Among 3,074 serum samples consecutively tested for anti-HCV antibodies, 588 were found to be positive by screening assays. Fifty-nine of them (10%) were RIBA3.0 indeterminate and were compared with 59 RIBA3.0-positive ones. Thirty-one RIBA3.0-indeterminate and 53 RIBA3.0-positive serum samples were HCV RNA positive by PCR (53 versus 90%; P < 10 ؊6). RIBA3.0-indeterminate and RIBA3.0-positive patients with positive PCR results were not significantly different for the prevalence of risk factors for HCV infection and elevated serum alanine aminotransferase activities. Immunosuppression, attributable to coexisting human immunodeficiency virus infection, organ transplantation, or the administration of immunosuppressive drugs, was significantly more frequent in PCR-positive, RIBA3.0-indeterminate patients than in PCR-negative, RIBA3.0-indeterminate patients (P < 0.001) and PCR-positive patients with a positive RIBA3.0 result (P < 0.01). The distribution of HCV genotypes did not differ significantly between HCV RNA-positive patients with indeterminate or positive RIBA3.0 results. In conclusion, the prevalence of indeterminate RIBA3.0 patterns in virology laboratories is about 10%; in about half of these patients HCV replication is detected by PCR; the main factor responsible for indeterminate RIBA3.0 patterns could be immunosuppression, whereas HCV genotypes do not seem to play a major role.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Significance of indeterminate third-generation hepatitis C virus recombinant immunoblot assay

et al. 1996

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“…Not all anti‐HCV positive patients remain viraemic. HCV‐RNA was demonstrated in 73–90% [7,15,18,19]. It is assumed that patients with antibodies to HCV who are HCV‐RNA negative, have cleared the virus and are not at risk for developing liver disease.…”

Section: Prevalence Of Infectionmentioning

confidence: 99%

Treatment of chronic hepatitis C in haemophilia patients

Meijer¹,

Smid²,

Meer³

2000

Haemophilia

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“…Thus, in a follow-up study of 81 patients who developed non-A, non-B hepatitis after receiving HCV-infected immune globulin, 52 of 56 (93%) were anti-HCV positive 6 to 12 months after infection and 45 of 65 (69%) were positive 9 to 10 years after infection (76). Loss of antibody is more common in those who have resolving disease clinically (12,76,372), but it is also observed in conjunction with development of immunocompromise from HIV infection (48,213,244,302). Loss of reactivity to only C100-3, the single antigen expressed in the initial assays, is more common than loss of reactivity to all antigens (325,372).…”

Section: Secondand Third-generation Assaysmentioning

confidence: 99%

Hepatitis C: progress and problems

Cuthbert

1994

Clin Microbiol Rev

153

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The hepatitis C virus (HCV), a single-stranded RNA virus, is the major cause of posttransfusion hepatitis. HCV isolates differ in nucleotide and amino acid sequences. Nucleotide changes are concentrated in hypervariable regions and may be related to immune selection. In most immunocompetent persons, HCV infection is diagnosed serologically, using antigens from conserved regions. Amplification of RNA may be necessary to detect infection in immunosuppressed patients. Transmission by known parenteral routes is frequent; other means of spread are less common and may represent inapparent, percutaneous dissemination. Infection can lead to classical acute hepatitis, but most infected persons have no history of acute disease. Once infected, most individuals apparently remain carriers of the virus, with varying degrees of hepatocyte damage and fibrosis ensuing. Chronic hepatitis may lead to cirrhosis and hepatocellular carcinoma. However, disease progression varies widely, from less than 2 years to cirrhosis in some patients to more than 30 years with only chronic hepatitis in others. Determinants important in deciding outcome are unknown. Alpha interferon, which results in sustained remission in selected patients, is the only available therapy. Long-term benefits from such therapy have not been demonstrated. Prevention of HCV infection by vaccination is likely to be challenging if ongoing viral mutation results in escape from neutralization and clearance.

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The presence of hepatitis C virus (HCV) antibody in human immunodeficiency virus-positive hemophilic men undergoing HCV "seroreversion"

Cited by 52 publications

References 15 publications

Significance of indeterminate third-generation hepatitis C virus recombinant immunoblot assay

Significance of indeterminate third-generation hepatitis C virus recombinant immunoblot assay

Treatment of chronic hepatitis C in haemophilia patients

Hepatitis C: progress and problems

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