Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Persistently abnormal liver function tests: Marker of occult hepatitis C?

05.01.2004


Patients with persistently abnormal liver function tests but no serologic evidence of liver disease may nevertheless have hepatitis C virus (HCV) infection, according to a study published in the January 1 issue of The Journal of Infectious Diseases, available online now.



Such occult (meaning hidden or concealed) infection is not supposed to occur--the conventional wisdom is that the virus leaves markers in serum or plasma, including specific antibodies and viral RNA, which have been the serologic cornerstones for diagnosing and monitoring HCV-infected patients. Although occult HCV infection generally appears to be mild, some patients have shown evidence of serious chronic liver injury. In addition, occult infection raises the possibility of disease spread via blood donations, hemodialysis and other procedures. Fortunately, the study also suggests a minimally invasive approach to detect occult infection.

The study, reported by a group headed by Vicente Carreño, MD, in Madrid, Spain, involved 100 patients with abnormally high levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) or gamma glutamyl transpeptidase (GGTP) for at least 12 months in whom all causes of liver disease, including HCV infection, had ostensibly been excluded. All three liver enzymes were elevated in eight patients, two of the enzymes in 48 and one enzyme in 44. For comparison, 30 patients with liver damage known to be of non-viral origin were also studied.


The investigators relied on two assays to demonstrate the presence or absence of HCV infection. First, using reverse transcription-polymerase chain reaction (RT-PCR) with primers from one region of the HCV genome, they detected the virus’s RNA in liver biopsies from 57 (57%) of the patients with abnormal liver enzymes of unknown etiology, compared to none of the biopsies from control patients. When primers from another region of the genome were used in the RT-PCR assay, HCV RNA was found in liver biopsies from 40 (70%) of the 57 patients. The second method used was in situ hybridization, which demonstrated positive-strand HCV RNA in liver biopsies from the same 57 patients, but in none of those from the controls, and negative-strand HCV RNA in 48 (84%). The investigators noted that the latter finding suggested viral replication, which involves synthesis of a negative RNA intermediary.

The RT-PCR assay also detected HCV RNA in peripheral-blood mononuclear cells from 40 (70%) of the 57 patients with occult infection. The clinical implication of this finding, the investigators noted, is that a high percentage of patients with occult HCV infection may be more easily and more safely identified by obtaining and testing blood cells rather than liver cells.

In an accompanying editorial, Hervé Lerat, MD, and F. Blaine Hollinger, MD, of Baylor College of Medicine, Houston, commented that the distribution of hepatic enzyme elevations in the study population implied that clinicians should use both ALT and GGT to identify patients who may qualify for peripheral-blood mononuclear cell testing for occult HCV infection. They cautioned, however, that many issues about such infections remain to be resolved, including the central issue of whether the detected viral genomic material is infectious.


Founded in 1904, The Journal of Infectious Diseases (JID) is the premier publication in the Western Hemisphere for original research on the pathogenesis, diagnosis and treatment of infectious diseases; on the microbes that cause them; and on disorders of host immune mechanisms. Articles in JID include research results from microbiology, immunology, epidemiology and related disciplines. JID is published under the auspices of the Infectious Diseases Society of America (IDSA), based in Alexandria, Va., a professional society representing more than 7,000 physicians and scientists who specialize in infectious diseases.

Note: Interviews with Drs. Carreño and Hollinger can be arranged by contacting Diana Olson at dolson@idsociety.org or 703-299-0201.

Diana Olson | EurekAlert!
Further information:
http://www.idsociety.org/

More articles from Health and Medicine:

nachricht Investigators may unlock mystery of how staph cells dodge the body's immune system
22.09.2017 | Cedars-Sinai Medical Center

nachricht Monitoring the heart's mitochondria to predict cardiac arrest?
21.09.2017 | Boston Children's Hospital

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: The pyrenoid is a carbon-fixing liquid droplet

Plants and algae use the enzyme Rubisco to fix carbon dioxide, removing it from the atmosphere and converting it into biomass. Algae have figured out a way to increase the efficiency of carbon fixation. They gather most of their Rubisco into a ball-shaped microcompartment called the pyrenoid, which they flood with a high local concentration of carbon dioxide. A team of scientists at Princeton University, the Carnegie Institution for Science, Stanford University and the Max Plank Institute of Biochemistry have unravelled the mysteries of how the pyrenoid is assembled. These insights can help to engineer crops that remove more carbon dioxide from the atmosphere while producing more food.

A warming planet

Im Focus: Highly precise wiring in the Cerebral Cortex

Our brains house extremely complex neuronal circuits, whose detailed structures are still largely unknown. This is especially true for the so-called cerebral cortex of mammals, where among other things vision, thoughts or spatial orientation are being computed. Here the rules by which nerve cells are connected to each other are only partly understood. A team of scientists around Moritz Helmstaedter at the Frankfiurt Max Planck Institute for Brain Research and Helene Schmidt (Humboldt University in Berlin) have now discovered a surprisingly precise nerve cell connectivity pattern in the part of the cerebral cortex that is responsible for orienting the individual animal or human in space.

The researchers report online in Nature (Schmidt et al., 2017. Axonal synapse sorting in medial entorhinal cortex, DOI: 10.1038/nature24005) that synapses in...

Im Focus: Tiny lasers from a gallery of whispers

New technique promises tunable laser devices

Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...

Im Focus: Ultrafast snapshots of relaxing electrons in solids

Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!

When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...

Im Focus: Quantum Sensors Decipher Magnetic Ordering in a New Semiconducting Material

For the first time, physicists have successfully imaged spiral magnetic ordering in a multiferroic material. These materials are considered highly promising candidates for future data storage media. The researchers were able to prove their findings using unique quantum sensors that were developed at Basel University and that can analyze electromagnetic fields on the nanometer scale. The results – obtained by scientists from the University of Basel’s Department of Physics, the Swiss Nanoscience Institute, the University of Montpellier and several laboratories from University Paris-Saclay – were recently published in the journal Nature.

Multiferroics are materials that simultaneously react to electric and magnetic fields. These two properties are rarely found together, and their combined...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

“Lasers in Composites Symposium” in Aachen – from Science to Application

19.09.2017 | Event News

I-ESA 2018 – Call for Papers

12.09.2017 | Event News

EMBO at Basel Life, a new conference on current and emerging life science research

06.09.2017 | Event News

 
Latest News

Rainbow colors reveal cell history: Uncovering β-cell heterogeneity

22.09.2017 | Life Sciences

Penn first in world to treat patient with new radiation technology

22.09.2017 | Medical Engineering

Calculating quietness

22.09.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>