Abstract
The epidemiology of hepatitis C virus (HCV) infection was studied in an English teaching hospital over an 18 month period. A total of 104 HCV antibody positive patients were referred for further investigation. They were divided into those diagnosed through screening (blood donors and intravenous drug abusers) and those diagnosed for other reasons, and their mean ages, known risk factors for HCV transmission, genotypes, and liver biopsy histology were analysed. Screened patients were significantly younger than the others. No significant difference in age was found between genotypes. Most patients genotyped (69%) were genotype 1. Intravenous drug abusers had a higher proportion of subtype 1a, and patients who acquired HCV through blood transfusion had a higher proportion of subtype 1b. Liver biopsy specimens were scored using a histological activity index for liver inflammation and fibrosis. Patients with subtype 1b had significantly more severe liver disease than other genotypes when the histological activity index scores for fibrosis were analysed (p < 0.05). Liver disease worsened significantly with age according to all three histological activity index scores (portal activity: p < 0.01, acinar activity: p < 0.001, fibrosis: p < 0.0001). Liver disease worsened with increased duration of infection (p < 0.002), and patients who also abused alcohol presented at a significantly younger age (cirrhosis, p < 0.05, hepatocellular carcinoma, p < 0.02).
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Selected References
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- Abildgaard N., Peterslund N. A. Hepatitis C virus transmitted by tattooing needle. Lancet. 1991 Aug 17;338(8764):460–460. doi: 10.1016/0140-6736(91)91095-c. [DOI] [PubMed] [Google Scholar]
- Allain J. P., Rankin A., Kuhns M. C., McNamara A. Clinical importance of HCV confirmatory testing in blood donors. Lancet. 1992 May 9;339(8802):1171–1172. doi: 10.1016/0140-6736(92)90772-u. [DOI] [PubMed] [Google Scholar]
- Ascher N. L., Lake J. R., Emond J., Roberts J. Liver transplantation for hepatitis C virus-related cirrhosis. Hepatology. 1994 Jul;20(1 Pt 2):24S–27S. doi: 10.1016/0270-9139(94)90269-0. [DOI] [PubMed] [Google Scholar]
- Becker M. D., Baptista A., Scheuer P. J., Sherlock S. Prognosis of chronic persistent hepatitis. Lancet. 1970 Jan 10;1(7637):53–57. doi: 10.1016/s0140-6736(70)91843-x. [DOI] [PubMed] [Google Scholar]
- Bresters D., Mauser-Bunschoten E. P., Reesink H. W., Roosendaal G., van der Poel C. L., Chamuleau R. A., Jansen P. L., Weegink C. J., Cuypers H. T., Lelie P. N. Sexual transmission of hepatitis C virus. Lancet. 1993 Jul 24;342(8865):210–211. doi: 10.1016/0140-6736(93)92300-i. [DOI] [PubMed] [Google Scholar]
- Brind A. M., Codd A. A., Cohen B. J., Gabriel F. G., Collins J. D., James O. F., Bassendine M. F. Low prevalence of antibody to hepatitis C virus in north east England. J Med Virol. 1990 Dec;32(4):243–248. doi: 10.1002/jmv.1890320409. [DOI] [PubMed] [Google Scholar]
- Bruno S., Rossi S., Petroni M. L., Villa E., Zuin M., Podda M. Normal aminotransferase concentrations in patients with antibodies to hepatitis C virus. BMJ. 1994 Mar 12;308(6930):697–697. doi: 10.1136/bmj.308.6930.697. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Chiaramonte M., Stroffolini T., Caporaso N., Coppola R., Craxì A., Gaeta G. B., Sagnelli E., Zanetti A. R. Hepatitis-C virus infection in Italy: a multicentric sero-epidemiological study (a report from the HCV study group of the Italian Association for the Study of the Liver). Ital J Gastroenterol. 1991 Dec;23(9):555–558. [PubMed] [Google Scholar]
- Chomczynski P., Sacchi N. Single-step method of RNA isolation by acid guanidinium thiocyanate-phenol-chloroform extraction. Anal Biochem. 1987 Apr;162(1):156–159. doi: 10.1006/abio.1987.9999. [DOI] [PubMed] [Google Scholar]
- Curtis S. Asymptomatic hepatitis C infection. Hepatitis C can be sexually transmitted. BMJ. 1994 May 7;308(6938):1235–1235. [PMC free article] [PubMed] [Google Scholar]
- Di Bisceglie A. M., Goodman Z. D., Ishak K. G., Hoofnagle J. H., Melpolder J. J., Alter H. J. Long-term clinical and histopathological follow-up of chronic posttransfusion hepatitis. Hepatology. 1991 Dec;14(6):969–974. doi: 10.1016/0270-9139(91)90113-a. [DOI] [PubMed] [Google Scholar]
- Dusheiko G., Schmilovitz-Weiss H., Brown D., McOmish F., Yap P. L., Sherlock S., McIntyre N., Simmonds P. Hepatitis C virus genotypes: an investigation of type-specific differences in geographic origin and disease. Hepatology. 1994 Jan;19(1):13–18. [PubMed] [Google Scholar]
- Fargion S., Piperno A., Cappellini M. D., Sampietro M., Fracanzani A. L., Romano R., Caldarelli R., Marcelli R., Vecchi L., Fiorelli G. Hepatitis C virus and porphyria cutanea tarda: evidence of a strong association. Hepatology. 1992 Dec;16(6):1322–1326. doi: 10.1002/hep.1840160603. [DOI] [PubMed] [Google Scholar]
- Garson J. A., Clewley J. P., Simmonds P., Zhang L. Q., Mori J., Ring C., Follett E. A., Dow B. C., Martin S., Gunson H. Hepatitis C viraemia in United Kingdom blood donors. A multicentre study. Vox Sang. 1992;62(4):218–223. doi: 10.1111/j.1423-0410.1992.tb01202.x. [DOI] [PubMed] [Google Scholar]
- Garson J. A., Tuke P. W., Makris M., Briggs M., Machin S. J., Preston F. E., Tedder R. S. Demonstration of viraemia patterns in haemophiliacs treated with hepatitis-C-virus-contaminated factor VIII concentrates. Lancet. 1990 Oct 27;336(8722):1022–1025. doi: 10.1016/0140-6736(90)92487-3. [DOI] [PubMed] [Google Scholar]
- Irving W. L., Neal K. R., Underwood J. C., Simmonds P. N., James V. Chronic hepatitis in United Kingdom blood donors infected with hepatitis C virus. Trent Regional Hepatitis C Virus Study Group. BMJ. 1994 Mar 12;308(6930):695–696. doi: 10.1136/bmj.308.6930.695. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lee H. S., Han C. J., Kim C. Y. Predominant etiologic association of hepatitis C virus with hepatocellular carcinoma compared with hepatitis B virus in elderly patients in a hepatitis B-endemic area. Cancer. 1993 Nov 1;72(9):2564–2567. doi: 10.1002/1097-0142(19931101)72:9<2564::aid-cncr2820720909>3.0.co;2-#. [DOI] [PubMed] [Google Scholar]
- McOmish F., Chan S. W., Dow B. C., Gillon J., Frame W. D., Crawford R. J., Yap P. L., Follett E. A., Simmonds P. Detection of three types of hepatitis C virus in blood donors: investigation of type-specific differences in serologic reactivity and rate of alanine aminotransferase abnormalities. Transfusion. 1993 Jan;33(1):7–13. doi: 10.1046/j.1537-2995.1993.33193142314.x. [DOI] [PubMed] [Google Scholar]
- Merican I., Sherlock S., McIntyre N., Dusheiko G. M. Clinical, biochemical and histological features in 102 patients with chronic hepatitis C virus infection. Q J Med. 1993 Feb;86(2):119–125. [PubMed] [Google Scholar]
- Mutimer D. J., Harrison R. F., O'Donnell K. B., Shaw J., Martin B. A., Atrah H., Ala F. A., Skidmore S., Hubscher S. G., Neuberger J. M. Hepatitis C in asymptomatic British blood donors with indeterminate seropositivity. BMJ. 1994 Oct 1;309(6958):847–848. doi: 10.1136/bmj.309.6958.847. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ryan K. E., MacLennan S., Barbara J. A., Hewitt P. E. Follow up of blood donors positive for antibodies to hepatitis C virus. BMJ. 1994 Mar 12;308(6930):696–697. doi: 10.1136/bmj.308.6930.696. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Saito I., Miyamura T., Ohbayashi A., Harada H., Katayama T., Kikuchi S., Watanabe Y., Koi S., Onji M., Ohta Y. Hepatitis C virus infection is associated with the development of hepatocellular carcinoma. Proc Natl Acad Sci U S A. 1990 Sep;87(17):6547–6549. doi: 10.1073/pnas.87.17.6547. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Scheuer P. J. Classification of chronic viral hepatitis: a need for reassessment. J Hepatol. 1991 Nov;13(3):372–374. doi: 10.1016/0168-8278(91)90084-o. [DOI] [PubMed] [Google Scholar]
- Shiell A., Briggs A., Farrell G. C. The cost effectiveness of alpha interferon in the treatment of chronic active hepatitis C. Med J Aust. 1994 Mar 7;160(5):268–272. [PubMed] [Google Scholar]
- Simmonds P., Alberti A., Alter H. J., Bonino F., Bradley D. W., Brechot C., Brouwer J. T., Chan S. W., Chayama K., Chen D. S. A proposed system for the nomenclature of hepatitis C viral genotypes. Hepatology. 1994 May;19(5):1321–1324. [PubMed] [Google Scholar]
- Stuyver L., Rossau R., Wyseur A., Duhamel M., Vanderborght B., Van Heuverswyn H., Maertens G. Typing of hepatitis C virus isolates and characterization of new subtypes using a line probe assay. J Gen Virol. 1993 Jun;74(Pt 6):1093–1102. doi: 10.1099/0022-1317-74-6-1093. [DOI] [PubMed] [Google Scholar]
- Tedder R. S., Gilson R. J., Briggs M., Loveday C., Cameron C. H., Garson J. A., Kelly G. E., Weller I. V. Hepatitis C virus: evidence for sexual transmission. BMJ. 1991 Jun 1;302(6788):1299–1302. doi: 10.1136/bmj.302.6788.1299. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ueda T., Ohta K., Suzuki N., Yamaguchi M., Hirai K., Horiuchi T., Watanabe J., Miyamoto T., Ito K. Idiopathic pulmonary fibrosis and high prevalence of serum antibodies to hepatitis C virus. Am Rev Respir Dis. 1992 Jul;146(1):266–268. doi: 10.1164/ajrccm/146.1.266. [DOI] [PubMed] [Google Scholar]
- Vucelić B., Hadzić N., Dubravcić D. Chronic persistent hepatitis. Long-term prospective study on the natural course of the disease. Scand J Gastroenterol. 1988 Jun;23(5):551–554. doi: 10.3109/00365528809093910. [DOI] [PubMed] [Google Scholar]
- Wang J. T., Wang T. H., Sheu J. C., Lin S. M., Lin J. T., Chen D. S. Effects of anticoagulants and storage of blood samples on efficacy of the polymerase chain reaction assay for hepatitis C virus. J Clin Microbiol. 1992 Mar;30(3):750–753. doi: 10.1128/jcm.30.3.750-753.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Zaaijer H. L., Cuypers H. T., Reesink H. W., Winkel I. N., Gerken G., Lelie P. N. Reliability of polymerase chain reaction for detection of hepatitis C virus. Lancet. 1993 Mar 20;341(8847):722–724. doi: 10.1016/0140-6736(93)90488-3. [DOI] [PubMed] [Google Scholar]
- van der Poel C. L., Cuypers H. T., Reesink H. W. Hepatitis C virus six years on. Lancet. 1994 Nov 26;344(8935):1475–1479. doi: 10.1016/s0140-6736(94)90293-3. [DOI] [PubMed] [Google Scholar]
