Prevalence of transfusion-acquired hepatitis C in an Australian bleeding disorders population.

In Australia prior to 1992, many patients with bleeding disorders were exposed to hepatitis C through blood products. However, the incidence, complications and response to treatment of chronic hepatitis C (CHC) in this population are poorly characterized. The aim of this study was to examine the prevalence of CHC and response to treatment in an Australian bleeding disorders population. Demographic data, virological data and liver disease status from these 700 patients with inherited bleeding disorders were analysed. Of these 700 patients, 424 (61%) had been tested for CHC infection and 219 (52%) were hepatitis C antibody positive, with the prevalence approaching 100% in patients with severe bleeding disorders. Of 219 patients, 73 (33%) had received treatment for their infection with a response rate of 33/73 (45%) across all genotypes. Of 219 patients, 34 (16%) had spontaneous viral clearance. When measured with transient elastography, 44/98 (45%) patients with CHC had significant liver fibrosis and 15/98 (15%) had liver cirrhosis. Of 130 patients, 38 (29%) with CHC infection had no evidence of follow-up with an appropriate clinician in the past 2 years. This study demonstrates that testing for CHC in this population is incomplete and treatment rates are low. Given the substantial morbidity and mortality associated with CHC and new therapeutic options becoming available, it seems important to reengage patients to diagnose, offer treatment and monitor this infection.

Anti-CD20 monoclonal antibodies: reviewing a revolution.

Since the inception of rituximab in the 1990s, anti-CD20 monoclonal antibodies have revolutionised the treatment of B cell hematological malignancies and have become a cornerstone of modern gold-standard practice. Additionally, the potent efficacy of these agents in depleting the B cell compartment has been used in the management of a broad array of autoimmune diseases. Multiple iterations of these agents have been investigated and are routinely used in clinical practice. In this review, we will discuss the physiology of CD20 and its attractiveness as a therapeutic target, as well as the pharmacology, pre-clinical and clinical data for the major anti-CD20 monoclonal antibodies: rituximab, obinutuzumab and ofatumumab.

Comparison of curvature-based and Shack-Hartmann-based adaptive optics for the Gemini telescope.

We present the results of independent numerical simulations of adaptive optics systems for 8-m astronomical telescopes that use both Shack-Hartmann and wave-front curvature sensors. Four differents codes provided consistency checks and redundancy. All four simulate a complete system and model noise and servo-lag effects. A common atmospheric turbulence generator was used for consistency. We present the main characteristics of the codes, and we report the system performance in term of Strehl ratio and full width at half-maximum versus the magnitude of the (on-axis) guide star. We show that a Shack-Hartmann plus stacked actuator mirror system with 10 x 10 subapertures or a curvature plus bimorph mirror system with 56 subapertures yields a 50% Strehl ratio at 1.6 mum for a m(R) = 14.7 magnitude star, with almost equivalent performance at both brighter and dimmer light levels.