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hepatitis c virus core antigen testing: Role in diagnosis, disease monitoring and treatment

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World Journal of Gastroenterology 2014年第22期20卷 6701-6706页

作者： Hans L Tillmann GI/Hepatology Duke Clinical Research Institute and Duke UniversityDurhamNC 27708United States

While hepatitis B virus(HBV)screening relies on hepatitis B surface antigen to confirm HBV infection since the early days of hepatitis B disease management,hepatitis c virus(HcV)infection screening is based on anti-HcV testing which does not discriminate active from past *** to confirm infection HcV RNA testing has been required;recently a HcV core antigen assay became widely commercially available which could serve to confirm *** assay is less sensitive than current HcV RNA assays,but as more than 50%of anti-HcV positive persons will be HcV core antigen positive,HcV core antigen testing can be a cost effective and reflex test to confirm HcV infection in anti-HcV positive individuals and will be easier as it can be applied on the same *** treatment monitoring,more data need to be generated,but the early data available at present suggest that HcV core antigen may be an alternative to HcV RNA *** direct antivirals,HcV core antigen could even be superior to HcV RNA testing,as direct antivirals might already prevent virus formation when HcV core antigen is still produced and thereby correlates better with eventual viral clearance.

关键词： hepatitis c virus hepatitis c Diagnostic assay Diagnostic accuracy hepatitis c virus core antigen Treatment monitoring

hepatitis c virus reactivation in cancer patients in the era of targeted therapies

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World Journal of Gastroenterology 2014年第22期20卷 6716-6724页

作者： Ozan Yazici Mehmet Ali Nahit ?endur Sercan Aksoy Department of Medical Oncology Ankara Numune Education and Research HospitalAnkara 06100Turkey Department of Medical Oncology Hacettepe University Cancer InstituteAnkara 06100Turkey

The purpose of this review is to summarize the evidence of hepatitis c reactivation in cancer patients in the era of targeted therapies. Targeted therapies are novel therapeutics frequently used in cancer patients. During treatment with targeted therapies, viral replication is one of the major problems that can occur. The PubMed database, AScO, and AScO Gastrointestinal cancer Symposium abstracts were searched up until September 15, 2013 using the following search keywords: “targeted therapies, rituximab, alemtuzumab, brentuximab, hepatitis, hepatitis c reactivation, tyrosine kinase inhibitors, imatinib, mammalian target of rapamycin (mTOR) inhibitors, everolimus, anti-HER therapies, trastuzumab, pertuzumab, lapatinib, anti-epidermal growth factor receptor therapies, cetuximab, panitumumab, and ipilimumab”. Papers considered relevant for the aim of this review were selected by the authors. The data about rituximab-induced hepatic flare in hepatitis c virus (HcV) positive patients is controversial. However, there is the possibility of life-threatening hepatic flare that can develop after HcV ribonucleic acid (HcV-RNA) viral load increases. Routine follow-up of liver function tests should be advised. Especially in high-risk patients, such as those with baseline chronic active hepatitis and cirrhosis, and where there are plans to administer rituximab concomitantly with corticosteroids, it is advised to have close follow-up of HcV viral load. The data is insufficient to make accurate statements about the association of alemtuzumab therapy and HcV reactivation. However, alemtuzumab may cause deep immunosuppression. Due to this, it is better to follow up with liver function tests and HcV RNA levels during alemtuzumab therapy. Brentuximab has effects on antibody dependent cellular toxicity and may decrease humoral immunity. Thus, we believe that during brentuximab treatment of HcV infected patients, clinicians may encounter hepatitis c reactivation. There h

关键词： hepatitis c hepatitis c reactivation Monoclonal antibodies cancer Rituximab

hepatitis c Screening: Barriers to Linkage to care

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Journal of clinical and Translational Hepatology 2019年第3期7卷 226-231页

作者： Sammy Saab Youssef Pchallita Lisa MNajarian Rong Guo Satvir SSaggi Gina choi Departments of Surgery University of California at Los AngelesLos AngelesCAUSA Departments of Medicine University of California at Los AngelesLos AngelesCAUSA Departments of Medicine Statistics core University of California at Los AngelesLos AngelesCAUSA

Background andAims:hepatitis c(HcV)is a medical and public health *** infected individuals are identified,management includes not only education but also the use of antiviral *** screening for HcV is readily available,barriers exist which prevent assessment and treatment in individuals potentially infected with ***:This is a retrospective study of patients screened for HcV within the University of california,Los Angeles Health care System between February 22 and July 9,*** defined linkage to care as:1)confirmatory HcV RNA test after screening HcV antibody test found a positive result;and 2)follow-up appointment for treatment was established with a *** and baseline laboratory values were *** potentially associated with prohibiting linkage of care were ***:During the study period,17,512 individuals were screened for HcV.A total of 238(1.35%)were found to have detectable HcV *** the individuals with detectable HcV antibodies,48(20%)did not undergo confirmatory testing with viral *** the 190 individuals who underwent further testing,70 patients were noted to be *** them,17 of the 70(24%)were not linked to a specialist for further *** patients(p=0.02)and people who inject drugs(p=0.02)were less likely to be referred for specialty ***:The results of our study highlight that younger patients and people who inject drugs are less likely to be referred to specialty care for HcV *** are needed to engage these populations.

关键词： hepatitis c Screening Linkage

hepatitis c Virus and Hepatocellular carcinoma:A Narrative Review

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Journal of clinical and Translational Hepatology 2018年第1期6卷 79-84页

作者： Page Axley Zunirah Ahmed Sujan Ravi Ashwani K. Singa Department of Medicine University of Alabama at BirminghamBirminghamALUSA Division of Gastroenterology and Hepatology University of Alabama at BirminghamAL 35294-0012USA

Hepatocellular carcinoma(Hcc)is a leading cause of liverrelated death *** c virus(HcV)infection is a major cause of advanced hepatic fibrosis and cirrhosis,with significantly increased risk for development of *** morbidity and mortality of HcV-related Hcc remains high,as rates of HcV cirrhosis continue to *** long-term goal of antiviral therapy for chronic HcV is to reduce complications from cirrhosis,including *** advent of new direct-acting antivirals with high rates of virological clearance has revolutionized cure of HcV *** the development of Hcc in HcV patients who achieve disease sustained virologic response is reduced,these patients remain at risk for Hcc,particularly those patients with advanced fibrosis and *** review outlines the epidemiology of Hcc in chronic HcV,various mechanisms,risk factors and pathophysiology that contribute to this disease process,screening recommendations,and the available data on the impact of new direct-acting antiviral treatment on the development on Hcc.

关键词： hepatitis c Hepatocellular carcinoma Direct-acting antiviral Viral hepatitis

hepatitis c: Milestones from discovery to clinical cure

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Military Medical Research 2021年第3期8卷 444-446页

作者： Wei Hu chao Zhang Ji-Jing Shi Ji-Yuan Zhang Fu-Sheng Wang Medical School of chinese PLA Beijing 100842China Department of Infectious Diseases the Fifth Medical Centre of Chinese PLA General HospitalNational Clinical Research Centre for Infectious DiseasesBeijing 100039China The central Laboratory the First People’s Hospital of ZhengzhouZhengzhou 450004China

On October 5th, 2020, Drs. Harvey J. Alter, Michael Houghton and charles M. Rice were rewarded with Nobel Prize in Physiology or Medicine for "the discovery of hepatitis c virus(HcV)". During the past 50 years, remarkable achievements have been made in treatment of HcV infection: it has changed from being a life-threatening chronic disease to being curable. In this commentary, we briefly summarized the milestone events in the "scientific journey" from the first report of non-A, non-B hepatitis and discovery of the pathogen(HcV) to final identification of efficacious direct-acting antivirals. Further, we address the challenges and unmet issues in this field.

关键词： hepatitis c Nobel prize 2020 Treatment Milestone event

hepatitis c in injection drug users: It is time to treat

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World Journal of Gastroenterology 2017年第20期23卷 3569-3571页

作者： Alberto Grassi Giorgio Ballardini Internal Medicine and Hepatology Division Infermi Hospital

Injection drug users(IDUs)are at risk of hepatitis c virus(HcV)infection,due to needle and syringe *** HcV infection is a major cause of liver-related morbidity and mortality but can be cured with antiviral treatment leading to sustained viral response(SVR).It is well demonstrated that,when close cooperation between specialists in drug addiction and psychiatrists is assured,patients on maintenance treatment with methadone/buprenorphine can be treated for HcV with response rate,tolerability and side effects similar to those reported in *** guidelines recommend that active injection drug use should not exclude patients from HcV treatment,but many services remain reluctant to treat *** significant pharmacodynamic interactions were reported between approved direct anti-viral agents(DAAs)and buprenorphine or *** adjustments are not recommended;therefore DAAs appear to be the"perfect"therapy for patients taking opiate substitutive *** suggestions have been recently recognized by the European Association for the Study of the Liver(EASL)and included in EASL Recommendations on Treatment of hepatitis c *** confirm that HcV treatment for IDUs should be considered on an individualized basis and delivered within a multidisciplinary team setting;a history of intravenous drug use and recent drug use at treatment initiation are not associated with reduced SVR and decisions to treat must be made on a case-by-case basis.

关键词： hepatitis c Drug users Peg-interferon Direct antiviral agents hepatitis c virus treatment

hepatitis c in the pediatric population: Transmission, natural history, treatment and liver transplantation

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World Journal of Gastroenterology 2014年第32期20卷 11281-11286页

作者： Saira Khaderi Ross Shepherd John A Goss Daniel Leung Division of Abdominal Transplantation Micheal E DeBakey Department of Surgery Baylor College of Medicine Houston TX 77030 United States Division of Pediatric Gastroenterology Hepatology Nutrition Texas Children’s Hospital Baylor College of Medicine Houston TX 77030 United States

The number of children affected by the hepatitis c virus (HcV) in the United States is estimated to be between 23000 to 46000. The projected medical cost for children with HcV in the United States is upwards of 200 million over the next decade. The implementation of routine screening of blood supply has virtually eliminated transmission via transfusion and vertical transmission is now the most common mode of infection in children. Infections acquired during infancy are more likely to spontaneously resolve and fibrosis of the liver tends to increase with age suggesting slow progressive histologic injury. Anti-viral treatment may be warranted in children with persistently elevated liver enzymes or with significant fibrosis on liver biopsy. current standard of care includes weekly pegylated interferon and ribavirin twice daily. Predictors of high sustained viral response include genotype 2 and 3 and low viral load in children with genotype 1 (< 600000 IU/mL). Triple therapy is associated with a significantly higher rate of sustained virologic response (> 90%). Only 34 pediatric patients were transplanted with hepatitis c between January 2008 and April 2013. The majority of pediatric patients were born prior to universal screening of blood products and, as of June 2013, there are only two pediatric patients awaiting liver transplantation for end-stage liver disease secondary to hepatitis c. Pediatric survival rates post-transplant are excellent but graft survival is noticeably reduced compared to adults (73.73% for pediatric patients at one year compared to 87.69% in adult patients). New safe potent, and all-oral effective antiviral therapies for recurrent HcV should help increase graft survival.

关键词： hepatitis c Liver transplantation Pediatric Infection Fibrosis Liver disease

hepatitis c virus positive patient diagnosed after detection of atypical cryoglobulin

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World Journal of clinical cases 2016年第3期4卷 81-87页

作者： Belkiz Ongen Fehime Benli Aksungar Bahattin cicek Isin Akyar Abdurrahman coskun Mustafa Serteser Ibrahim Unsal Department of Biochemistry Acibadem Labmed Clinical Labo-ratories Department of Biochemistry Acibadem University School of Medicine Department of Internal Medicine-Gastroen-terology Acibadem University School of Medicine Department of Microbiology Acibadem University School of Medicine

A 60-year-old male patient presented with jaundice and dark urine for three days, icteric sclerae and skin rash on his legs for six months. Laboratory investigations revealed an atypical cryoglobulinemia with high hepatitis c virus(HcV)-RNA levels. Imaging studies showed cholestasis was accompanying HcV. capillary zone electrophoresis using immunosubtraction method revealed a polyclonal immunoglobulin G and immunoglobulin A(IgA) monoclonal cryoglobulin and that Ig A lambda was absent in immunofixation electrophoresis. After a liver biopsy, chronic hepatitis c, HcV related mixed cryoglobulinemia and cryoglobulinemic vasculitis were diagnosed and antiviral therapy was initiated. Our HcV patient presented with cryoglobulinemic symptoms with an atypical cryoglobulinemia that was detected by an alternative method: Immunosubtraction by capillary electrophoresis. Different types of cryoglobulins may therefore have a correlation with clinical symptoms and prognosis. Therefore, the accurate immunotyping of cryoglobulins with alternative methods may provide more information about cryoglobulin-generated pathology.

关键词： cryoglobulinemia hepatitis c Immunosu-btraction Immunotyping Electrophoresis

Hep-Pred: hepatitis c Staging Prediction Using Fine Gaussian SVM

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computers, Materials & continua 2021年第10期69卷 191-203页

作者： Taher M.Ghazal Marrium Anam Mohammad Kamrul Hasan Muzammil Hussain Muhammad Sajid Farooq Hafiz Muhammad Ammar Ali Munir Ahmad Tariq Rahim Soomro center for cyber Security Faculty of Information Science and TechnologyUniversiti Kebansaan Malaysia(UKM)Bangi43600SelangorMalaysia School of Information Technology Skyline University CollegeUniversity City SharjahSharjah1797UAE Department of computer Science Government College UniversityFaisalabad38000Pakistan Department of computer Science School of Systems and TechnologyUniversity of Management and TechnologyLahore54000Pakistan Department of computer Science Lahore Garrison UniversityLahore54000Pakistan School of computer Science National College of Business Administration&EconomicsLahore54000Pakistan ccSIS Institute of Business ManagementKarachi75190SindhPakistan

hepatitis c is a contagious blood-borne infection,and it is mostly asymptomatic during the initial ***,it is difficult to diagnose and treat patients in the early stages of *** disease’s progression to its last stages makes diagnosis and treatment more *** this study,an AI system based on machine learning algorithms is presented to help healthcare professionals with an early diagnosis of hepatitis *** dataset used for our Hep-Pred model is based on a literature study,and includes the records of 1385 patients infected with the hepatitis c *** in this dataset received treatment dosages for the hepatitis c virus for about 18 months.A former study divided the disease into four main *** stages have proven helpful for doctors to analyze the liver’s *** traditional way to check the staging is the biopsy,which is a painful and time-consuming *** article aims to provide an effective and efficient approach to predict hepatitis c *** this purpose,the proposed technique uses a fine Gaussian SVM learning algorithm,providing 97.9%accurate results.

关键词： hepatitis c artificial intelligence Hep-Pred support vector machine machine learning hepatitis staging