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A Protocol for Analyzing Hepatitis C Virus Replication
Published on: June 26, 2014
Identified cases of acute hepatitis C from computerized laboratory database: a hospital-based epidemiological and
Chao-Hung Hung1, Sheng-Nan Lu, Jing-Houng Wang
1Division of Hepatogastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, 123 Ta Pei Road, Niao Sung 833, Kaohsiung, Taiwan.
Insights
Identifying acute hepatitis C (AHC) is challenging. A new method using rising antibody titers in lab databases can find more AHC cases, aiding in understanding its epidemiology and clinical outcomes.
Area of Science:
- Hepatology
- Infectious Diseases
- Virology
Background:
- Diagnosis of acute hepatitis C (AHC) typically requires documented seroconversion, which is rarely observed.
- This diagnostic challenge limits understanding of AHC epidemiology and clinical presentation.
Purpose of the Study:
- To identify additional AHC cases by employing a supplemental criterion of rising anti-HCV titer.
- To clarify the epidemiology and clinical course of AHC.
Main Methods:
- Computerized laboratory databases of anti-HCV and ALT were reviewed.
- AHC candidates were identified by seroconversion, rising anti-HCV titer (S/CO ratio < 40 to ≥ 40), or spontaneous HCV RNA clearance.
- A case-control study interviewed AHC cases and matched controls regarding risk factors.
Main Results:
- 123 AHC patients were identified, showing higher rates of recent surgery and injection therapy compared to controls.
- Self-limited AHC was observed in 19.1% of followed patients.
- Higher bilirubin levels were associated with self-limited AHC compared to chronic infection.
Conclusions:
- Screening laboratory databases for anti-HCV and ALT can identify more AHC candidates.
- This approach aids in revealing the epidemiology and clinical course of AHC.
Objective:
Diagnosis of acute hepatitis C (AHC) relies on documented positive-seroconversion of antibody to hepatitis C virus (anti-HCV) that is infrequently encountered. To clarify the epidemiology and clinical course of AHC, we tried to find more AHC patients from a computerized laboratory database by using a supplemental criterion of rising anti-HCV titer.
Methods:
All the computerized laboratory databases of anti-HCV and alanine aminotransferase (ALT) were reviewed. Candidates for AHC were identified by either anti-HCV positive seroconversion, rise of anti-HCV titer (signal to cut-off ratio (S/CO) ratio < 40 to > or = 40), or spontaneous HCV RNA clearance. AHC cases and their matched chronic hepatitis C controls were interviewed by a case-control study concerning risk factors.
Results:
AHC was identified in 123 patients (68 men and 55 women; median age: 48.4+/-13.9 years), who had higher rates of recent surgery (p=0.037) and frequent injection therapy (p=0.036) compared to controls. Self-limited AHC was observed in 18 (19.1%, 95% confidence interval: 12.3-25.9%) of 94 AHC patients who had been followed for 6 months, with a higher bilirubin level (> or = 2 vs. < 2, p=0.007) compared to those evolved to chronic infection.
Conclusions:
Screening of a laboratory database for anti-HCV and ALT might uncover more AHC candidates to disclose the epidemiology and clinical course of AHC.
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