Diagnostic Performance of Two Point-of-Care Tests for Anti-HCV Detection.

BACKGROUND: Besides the great importance of the issue in terms of public health, there is a lack of studies evaluating the performance of several of the currently used point of care tests (POCTs) for the detection of anti-HCV. OBJECTIVES: To investigate the performance of two POCTs for anti-HCV detection and to assess the impact of the reading time on diagnostic performance. PATIENTS AND METHODS: A total of 307 subjects were divided into three groups (1- HCV infected; 2- other chronic liver diseases; and 3- controls). The POCTs HCV Rapid Test Bioeasy® and Imuno-Rapido HCV® were read at 3, 5, 10, 15, 20 and 30 minutes. The sensitivity and specificity of the POCTs were calculated in relation to anti-HCV detection by chemiluminescence. RESULTS: Valid results were obtained for all tests. When compared to the chemiluminescence, both tests showed sensitivity of 97.1% and specificity of 100%. No changes in the sensitivity or specificity of the tests were observed at different reading times and when patients with other chronic liver diseases were evaluated as a control group. CONCLUSIONS: The POCTs evaluated in this study showed high sensitivity and specificity, with no change in the performance after the third minute of reading.

Cholestasis as the initial presentation of relapsing polychondritis.

Relapsing polychondritis is an immune-mediated disease associated with inflammation in cartilaginous structures and other tissues throughout the body, particularly the ears, nose, eyes, joints, and respiratory tract. Although association with other conditions is seen in about one-third of the cases, liver involvement is not usually observed in those patients. We described a case of liver involvement in relapsing polychondritis, presenting with a predominantly cholestatic pattern. Other conditions associated with abnormal liver tests were excluded and the patient showed a prompt response to steroid therapy. We discuss the spectrum of the liver involvement in relapsing and review the literature.

Radiographic alterations in patients presenting human immunodeficiency virus/tuberculosis coinfection: correlation with CD4+ T cell counts.

OBJECTIVE: To look for correlations between radiological patterns and CD4+ T cell counts in patients coinfected with tuberculosis and human immunodeficiency virus. METHODS: Patients included were selected from among those presenting human immunodeficiency virus/tuberculosis coinfection and admitted to the Nereu Ramos Hospital, located in Florianópolis, Brazil, between January of 2000 and December of 2003. RESULTS: A total of 87 patients were included. The mean age was 34 +/- 8 years, and 6.8% were non-Caucasian. The mean CD4+ T cell count was 220.2 cells/mm(3) (median, 144 cells/mm(3)), and 56.4% of the patients presented less than 200 cells/mm(3). We identified the following radiographic patterns and related them to the CD4+ T cell counts: the alveolar pattern in 50.6% of the cases (56.8% CD4+ T cells < 200); the interstitial pattern in 32.2% (53.6% CD4+ T cells < 200); pleural effusion in 24.1% (47.6% CD4+ T cells < 200); cavitation in 24.1% (57.1% CD4+ T cells < 200); enlarged mediastinal or hilar lymph nodes in 11.5% (90% CD4+ T cells < 200); and a normal pattern in 11.5% (60% CD4+ T cells < 200). The mean CD4+ T cell counts for the radiologic patterns isolated were as follows: 235.2/mm(3) (alveolar consolidation); 208.8/mm(3) (interstitial); 243.3/mm(3) (pleural effusion); 265/mm(3) (cavitation); 115.1/mm(3) (enlarged mediastinal or hilar lymph nodes) (p < 0.05); and 205.5/mm(3) (presenting no radiological alterations). As noted, mediastinal/hilar lymph node enlargement was the only pattern that correlated with the degree of cell-mediated immunity in a statistically significant way. CONCLUSION: With the exception of mediastinal/hilar lymph node enlargement, the radiographic patterns were randomly distributed in relation to the CD4+ T cell counts.