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HCV seroreactivity and detection of HCV RNA in cirrhotics
N Berry1, A Chakravarti, U Das
1Department of Microbiology, Maulana Azad Medical College, New Delhi, India.
Insights
Hepatitis C virus (HCV) infection is prevalent in cirrhotic patients, often co-occurring with Hepatitis B virus (HBV). Detecting both HCV RNA and anti-HCV antibodies improves diagnosis accuracy in cirrhosis cases.
Area of Science:
- Hepatology
- Virology
- Gastroenterology
Background:
- Hepatitis C virus (HCV) infection is a significant cause of liver cirrhosis.
- Coinfection with Hepatitis B virus (HBV) is common in HCV-infected patients, particularly in certain geographic regions.
- Accurate diagnosis of active HCV infection in cirrhotic patients is crucial for management.
Purpose of the Study:
- To determine the prevalence of HCV infection in patients with liver cirrhosis.
- To compare serological profiles with HCV RNA detection using RT-PCR.
- To investigate HBV coinfection and its impact on liver function in Indian cirrhotic patients.
Main Methods:
- Sera from 62 cirrhotic patients and 62 controls were tested for HCV using ELISA and nested RT-PCR.
- HBV serology (HBsAg, anti-HBc) and liver function tests were performed.
- HCV RNA and anti-HCV antibody presence was analyzed in relation to clinical and liver function profiles.
Main Results:
- HCV infection was detected in 38.7% of cirrhotic patients.
- Of those with HCV, 70.8% showed evidence of past or current HBV infection.
- No significant differences in liver function profiles were observed between HCV-infected and uninfected cirrhotics, or between HCV/HBV coinfected and HCV-monoinfected patients.
- HCV RNA and anti-HCV antibodies were simultaneously present in only 11.3% of cases, suggesting combined testing is beneficial.
Conclusions:
- HCV infection is common in Indian patients with liver cirrhosis, frequently associated with HBV coinfection.
- Combined testing for HCV RNA and anti-HCV antibodies is recommended for improved diagnostic sensitivity in cirrhosis.
- A significant proportion of cirrhotic patients (25.8%) had non-B, non-C cirrhosis, warranting further investigation for other hepatitis viruses.
Abstract:
This study was carried out to determine the presence of HCV infection in cirrhotic patients and to compare their serologic profiles with detection of HCV RNA by RT-PCR. Liver function profiles were assessed and correlated with infection. Coinfection of HCV with HBV was studied in the Indian context Sera from 62 patients of biopsy confirmed cirrhosis and an equal number of asymptomatic controls were tested for HCV by two ELISA (third generation) kits and nested reverse transcription PCR using primers from the 5'NCR. Other tests included HBV serology (ELISA for HBsAg and anti-HBc) and liver function tests. Twenty-four (38.7%) cases were HCV infected, of which 17 (70.8%) had past exposure to HBV or were coinfected with HBV (either being chronically infected or carriers of HBV). There was no significant difference in the clinical and liver function profiles of HCV infected and uninfected cirrhotics. Similarly, no difference was observed in cases coinfected with both HCV and HBV compared with those infected with HCV alone. Although the difference between positivity of HCV RNA and of anti-HCV was not significant, HCV RNA and anti HCV were present together in only 7/62 (11.3%) cases. Thus testing for both antibody and HCV RNA would be more appropriate than either test alone. HBV infection was seen in about one-fourth of HCV infected cirrhotics. About one-fourth (25.8%) patients had non-B, non-C cirrhosis in whom testing for HCV variants and other recently characterized hepatitis viruses could be performed.