title: The natural history of recent hepatitis C virus infection among blood donors and injection drug users in the country of Georgia.
abstract: BACKGROUND
  Hepatitis C virus (HCV) infection is a serious health problem in Georgia.
  
  
  METHODS
  We conducted a prospective study to identify and characterize the natural history of recent HCV infection since very first days of infection. Recent HCV infection was defined as detectable plasma HCV RNA in the absence of anti-HCV antibodies.
  
  
  RESULTS
  A total of 7600 HCV seronegative blood donors and 3600 HCV seronegative drug users were screened for recent HCV infection. Among them 7 (0.09 %) blood donors and 10 (0.28 %) drug users tested positive for HCV RNA and were classified as having recent HCV infection. Of these 17 patients 4 (23.5 %) spontaneously cleared the virus by the end of 24 week follow-up. Five clinical forms of recent HCV infection were identified during the follow-up. Four patients had symptomatic disease, including 3 patients with jaundice and other clinical symptoms (2 of them cleared virus) and 1 patient only had other symptoms without jaundice. All symptomatic patients had ALT elevation. Three distinct variants of asymptomatic disease were identified in 13 patients: 9 patients had ALT elevation and none cleared the virus; 2 patients developed chronic disease without ALT elevation; 2 patients cleared virus without anti-HCV seroconversion and without ALT elevation; this form can be described as transitory HCV viremia.
  
  
  CONCLUSIONS
  Additional studies are needed to define clinical and public health implications of transitory HCV viremia. Our study suggests the need for implementing nucleic acid testing of blood donors and key populations in order to more effectively identify HCV infected persons.
authors: Faculty of Medicine, Ivane Javakhishvili Tbilisi State University, 16 Al. Kazbegi Avenue, Tbilisi, 0160, Georgia. tengizt@gol.ge.|Infectious Diseases, AIDS and Clinical Immunology Research Center, 16 Al. Kazbegi Avenue, Tbilisi, 0160, Georgia. tengizt@gol.ge.|Georgian-French Joint Hepatology Clinic 'Hepa', 16 Al. Kazbegi Avenue, Tbilisi, 0160, Georgia. tengizt@gol.ge.
authors: Tengiz
authors: T
authors: Tsertsvadze
authors: Faculty of Medicine, Ivane Javakhishvili Tbilisi State University, 16 Al. Kazbegi Avenue, Tbilisi, 0160, Georgia. sharvadzel@yahoo.com.|Infectious Diseases, AIDS and Clinical Immunology Research Center, 16 Al. Kazbegi Avenue, Tbilisi, 0160, Georgia. sharvadzel@yahoo.com.|Georgian-French Joint Hepatology Clinic 'Hepa', 16 Al. Kazbegi Avenue, Tbilisi, 0160, Georgia. sharvadzel@yahoo.com.
authors: Lali
authors: L
authors: Sharvadze
authors: Infectious Diseases, AIDS and Clinical Immunology Research Center, 16 Al. Kazbegi Avenue, Tbilisi, 0160, Georgia. nikoloch@yahoo.com.
authors: Nikoloz
authors: N
authors: Chkhartishvili
authors: Infectious Diseases, AIDS and Clinical Immunology Research Center, 16 Al. Kazbegi Avenue, Tbilisi, 0160, Georgia. dzigu14@yahoo.com.
authors: Lela
authors: L
authors: Dzigua
authors: Infectious Diseases, AIDS and Clinical Immunology Research Center, 16 Al. Kazbegi Avenue, Tbilisi, 0160, Georgia. kmarika79@yahoo.com.|Georgian-French Joint Hepatology Clinic 'Hepa', 16 Al. Kazbegi Avenue, Tbilisi, 0160, Georgia. kmarika79@yahoo.com.
authors: Marine
authors: M
authors: Karchava
authors: Infectious Diseases, AIDS and Clinical Immunology Research Center, 16 Al. Kazbegi Avenue, Tbilisi, 0160, Georgia. lgatserelia@yahoo.com.|Georgian-French Joint Hepatology Clinic 'Hepa', 16 Al. Kazbegi Avenue, Tbilisi, 0160, Georgia. lgatserelia@yahoo.com.
authors: Lana
authors: L
authors: Gatserelia
authors: Infectious Diseases, AIDS and Clinical Immunology Research Center, 16 Al. Kazbegi Avenue, Tbilisi, 0160, Georgia. akakiabutidze@yahoo.com.|Georgian-French Joint Hepatology Clinic 'Hepa', 16 Al. Kazbegi Avenue, Tbilisi, 0160, Georgia. akakiabutidze@yahoo.com.
authors: Akaki
authors: A
authors: Abutidze
authors: Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Room E7638, Baltimore, Maryland, 21205, USA. knelson3@jhu.edu.
authors: Kenrad E
authors: KE
authors: Nelson
mesh_terms: D000328:Adult; D001782:Blood Donors; D055030:Drug Users; D005260:Female; D005846:Georgia (Republic) / Q000453:epidemiology; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006526:Hepatitis C / Q000097:blood / Q000453:epidemiology* / Q000276:immunology / Q000635:transmission / Q000821:virology*; D018937:Hepatitis C Antibodies / Q000097:blood / Q000276:immunology; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012367:RNA, Viral; D019562:Viral Load; D055815:Young Adult
chemical_list: D018937:Hepatitis C Antibodies; D012367:RNA, Viral