title: Demonstration of viraemia patterns in haemophiliacs treated with hepatitis-C-virus-contaminated factor VIII concentrates.
abstract: Sequential serum samples from previously untreated haemophiliacs in whom non-A, non-B hepatitis (NANBH) developed after they received factor VIII concentrate contaminated with hepatitis C virus (HCV) were tested by a commercial assay for the presence of antibodies to the C100 protein of HCV (anti-C100) and by "nested" PCR for the presence of HCV RNA sequences. Three temporal patterns of viraemia were observed: transient viraemia in acute resolving NANBH; viraemia lasting for several years in chronic NANBH; and intermittent viraemia in chronic NANBH, with an initial transient phase followed by recurrence after many months. In three of five cases the initial detection of serum HCV RNA was made before the onset of liver function test abnormality, many weeks or months before anti-C100 seroconversion. Diagnosis of acute HCV infection may therefore be possible much earlier by PCR than by existing serological techniques, but the timing of samples may be critical.
authors.affiliation: Department of Medical Microbiology, University College and Middlesex School of Medicine, London, UK.
authors.forename: J A
authors.initials: JA
authors.lastname: Garson
authors.forename: P W
authors.initials: PW
authors.lastname: Tuke
authors.forename: M
authors.initials: M
authors.lastname: Makris
authors.forename: M
authors.initials: M
authors.lastname: Briggs
authors.forename: S J
authors.initials: SJ
authors.lastname: Machin
authors.forename: F E
authors.initials: FE
authors.lastname: Preston
authors.forename: R S
authors.initials: RS
authors.lastname: Tedder
mesh_terms: D000208:Acute Disease; D000410:Alanine Transaminase / Q000097:blood; D000956:Antigens, Viral; D001483:Base Sequence; D004340:Drug Contamination; D005169:Factor VIII / Q000627:therapeutic use*; D006467:Hemophilia A / Q000382:microbiology* / Q000628:therapy; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology*; D006508:Hepatitis Antibodies / Q000032:analysis*; D006526:Hepatitis C / Q000175:diagnosis* / Q000209:etiology; D006521:Hepatitis, Chronic / Q000097:blood / Q000382:microbiology; D006801:Humans; D008297:Male; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction / Q000379:methods; D012367:RNA, Viral / Q000032:analysis; D011994:Recombinant Proteins / Q000737:chemistry*; D012008:Recurrence; D013997:Time Factors; D017361:Viral Nonstructural Proteins; D014764:Viral Proteins / Q000737:chemistry*; D014766:Viremia / Q000175:diagnosis* / Q000209:etiology / Q000235:genetics / Q000276:immunology
chemical_list: D000956:Antigens, Viral; C064544:C100 protein, hepatitis C virus; D006508:Hepatitis Antibodies; D012367:RNA, Viral; D011994:Recombinant Proteins; D017361:Viral Nonstructural Proteins; D014764:Viral Proteins; D005169:Factor VIII; D000410:Alanine Transaminase