title: Frequent detection of HCV RNA and HCVcoreAg in stool of patients with chronic hepatitis C.
abstract: HCV is transmitted mainly by parenteral routes. However, unprotected anal intercourse has also been identified as a risk factor for HCV infection. HCV RNA can be detected in blood, saliva, and bile, but the presence of HCV in stool has not been investigated yet.
  
  
  
  Therefore, stool samples of 98 patients were collected prospectively. Specific HCV primers were used to identify samples positive for HCV RNA. HCV RNA-positive samples were tested for HCVcoreAg with the Architect HCVAg assay (Abbott). Presence of occult blood was investigated by the hemoCARE guajak test. Viral stability and infectivity of recombinant HCV particles was investigated in vitro by incubation of genotype 2a chimeric virus Jc1 with bile and stool suspensions.
  
  
  
  HCV RNA could be detected in 68 out of 98 stool samples from patients with chronic hepatitis C and 16 samples also tested positive for HCVcoreAg. Presence of HCV RNA in stool was more frequent in male than in female and in patients with low platelet counts but was not associated with the detection of occult blood. Stool suspensions and to a lesser extent bile reduced the in vitro infectivity of genotype 2a chimeric Jc1 virus even though infection of Huh7 cells was not completely abrogated.
  
  
  
  In summary, this study shows for the first time that HCV can frequently be detected in stool samples of chronically infected patients irrespective of occult bleeding. We suggest that stool can be a potential source for HCV infection and thus unprotected anal intercourse should be avoided.
authors.affiliation: Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany; Microbial Interactions and Processes Research Group, Helmholtz Centre for Infection Research, Inhoffenstraße 7, 38124 Braunschweig, Germany; German Center for Infection Research (DZIF), partner site Hannover-Braunschweig, Inhoffenstraße 7, 38124 Braunschweig, Germany. Electronic address: Heidrich.Benjamin@mh-hannover.de.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Heidrich
authors.affiliation: Institute for Experimental Virology, TWINCORE Centre for Experimental and Clinical Infection Research, Feodor-Lynen-Straße 7, 30625 Hannover, Germany. Electronic address: eike.steinmann@twincore.de.
authors.forename: Eike
authors.initials: E
authors.lastname: Steinmann
authors.affiliation: Microbial Interactions and Processes Research Group, Helmholtz Centre for Infection Research, Inhoffenstraße 7, 38124 Braunschweig, Germany. Electronic address: Iris.Plumeier@helmholtz-hzi.de.
authors.forename: Iris
authors.initials: I
authors.lastname: Plumeier
authors.affiliation: Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany. Electronic address: Kirschner.Janina@mh-hannover.de.
authors.forename: Janina
authors.initials: J
authors.lastname: Kirschner
authors.affiliation: Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany. Electronic address: Sollik.Lisa@mh-hannover.de.
authors.forename: Lisa
authors.initials: L
authors.lastname: Sollik
authors.affiliation: Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany. Electronic address: Ziegert.Szilvia@mh-hannover.de.
authors.forename: Szilvia
authors.initials: S
authors.lastname: Ziegert
authors.affiliation: Institute for Experimental Virology, TWINCORE Centre for Experimental and Clinical Infection Research, Feodor-Lynen-Straße 7, 30625 Hannover, Germany. Electronic address: Michael.engelmann@twincore.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Engelmann
authors.affiliation: Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany. Electronic address: Lehmann.Patrick@mh-hannover.de.
authors.forename: Patrick
authors.initials: P
authors.lastname: Lehmann
authors.affiliation: Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany; German Center for Infection Research (DZIF), partner site Hannover-Braunschweig, Inhoffenstraße 7, 38124 Braunschweig, Germany. Electronic address: Manns.Michael@mh-hannover.de.
authors.forename: Michael Peter
authors.initials: MP
authors.lastname: Manns
authors.affiliation: Microbial Interactions and Processes Research Group, Helmholtz Centre for Infection Research, Inhoffenstraße 7, 38124 Braunschweig, Germany. Electronic address: Heidrich.Benjamin@mh-hannover.de.
authors.forename: Dietmar Helmut
authors.initials: DH
authors.lastname: Pieper
authors.affiliation: Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany; German Center for Infection Research (DZIF), partner site Hannover-Braunschweig, Inhoffenstraße 7, 38124 Braunschweig, Germany. Electronic address: Heidrich.Benjamin@mh-hannover.de.
authors.forename: Heiner
authors.initials: H
authors.lastname: Wedemeyer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005243:Feces / Q000821:virology*; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification* / Q000378:metabolism; D018936:Hepatitis C Antigens / Q000302:isolation & purification* / Q000378:metabolism; D019698:Hepatitis C, Chronic / Q000635:transmission / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011446:Prospective Studies; D012367:RNA, Viral / Q000235:genetics; D012737:Sex Factors; D012725:Sexual Behavior
chemical_list: D018936:Hepatitis C Antigens; D012367:RNA, Viral
keywords: HCV; HCV RNA; HCVcoreAg; Hepatitis C; Transmission