The course of hepatitis C viraemia in transfusion recipients prior to availability of antiviral ther

January 12, 2008

J Viral Hepat. 2008 Feb;15(2):120-8.

The course of hepatitis C viraemia in transfusion recipients prior to

availability of antiviral therapy.

Mosley JW, Operskalski EA, Tobler LH, Buskell ZJ, s WW, Phelps B, Dockter

J, Giachetti C, Seeff LB, Busch MP; for the Transfusion-transmitted Viruses

Study and Retrovirus Epidemiology Donor Study Groups.

Keck School of Medicine, University of Southern California, Los Angeles, CA,

USA.

Knowing the likely distribution of intervals from hepatitis C infection to first

RNA-negativity is important in deciding about therapeutic intervention.

Prospectively collected sera and data from the Transfusion-transmitted Viruses

Study (1974-1980) provide specific dates of infection and pattern of alanine

aminotransferase (ALT) elevations. We examined frequency, timing and correlates

of spontaneous resolution for 94 acutely infected transfusion recipients

followed for a median of 9.5 months. Later, follow-up sera (>10 years) were

available for 27 of the 94 cases from a Veterans Administration (VA) Study

(1989-1990). Twenty-five (27%) of the 94 cases were classified as probably

resolved during the episode itself. First RNA negativity occurred at 6-50 weeks

(median, 19.5 weeks) after infection, and 5-43 weeks (median, 11 weeks) after

ALT elevation. Thirteen of the 25 cases remained RNA-negative subsequently; 12

others had 1-6 RNA-positive sera intercalated between first and last

RNA-negative results. RNA negativity, therefore, began variably and was

interrupted in 12 cases of 25 (48%) by transient RNA-positive sera. Five of

these 25 patients who were RNA-negative in the last study specimen had late,

Veterans Administration Study follow-up; none showed viraemia. Of the remaining

69 transfusion transmitted virus study recipients, whose last serum was

RNA-positive, two cleared viraemia after the last study serum but before late

follow-up. Eleven (16%) had 23 intercalated RNA-negative sera before last

positivity. RNA status, therefore, needs monitoring for many months before

judging the spontaneous outcome as transient negativity may occur. Resolution

was significantly more common in women and symptomatic cases; it was not

associated with viral load in the infectious donation, HCV genotype, or the

recipient's age.

PMID: 18184195 [PubMed - in process]

_________________________________________________________________

Share life as it happens with the new Windows Live.

Recommended Posts