Long-term persistence of anti-rods and rings antibodies in patients with chronic hepatitis C after antiviral treatment.

Anti-rods and rings (anti-RR) antibodies are related to hepatitis C virus (HCV) in patients treated with pegylated interferon (PEG-IFN) and ribavirin (RBV). Only RBV induces rods/rings structures in vitro; but in vivo, the antibody appearance is related to the combination of these drugs, because data about patients using just one of these drugs alone is missing. Some studies suggest disappearance of these antibodies over time. The aim of this study was to describe the occurrence of anti-RR in patients with chronic hepatitis C treatment-naïve or previously PEG-IFN/RBV-experienced, evaluating the persistence of anti-RR antibodies long after PEG-IFN/RBV treatment. From 2016 to 2017, 70 HCV-infected patients were screened for anti-RR using indirect immunofluorescence. Demographic and clinical data about previous treatments against HCV were assessed. Thirty-four patients (49%) had been previously treated with PEG-IFN/RBV and the average time since they had received the last antiviral treatment was 85.4 months. Anti-RR seropositivity was detected in 16 patients (23%), and all of these had used PEG-IFN/RBV (corresponding to 47% of experienced patients). Previous antiviral treatment and previous exposure time to RBV were associated with anti-RR positivity. Median time elapsed since last treatment was similar between anti-RR-positive and anti-RR-negative patients. Anti-RR seropositivity was not observed in treatment-naïve patients, but was detected in almost half of patients previously treated with PEG-IFN and RBV, even after a long period without exposure to these drugs. This antibody was related to extended prior exposure to ribavirin.

Evaluation of viral load in saliva from patients with chronic hepatitis C infection.

Hepatitis C virus can be detected in blood and other bodily fluids, such as saliva. The aim of this study was to detect and quantify the HCV-RNA in saliva and plasma from patients with chronic hepatitis C infections, as well as check the level of viral load in sex groups (age, ethnicity and virus subtypes). Whole saliva and blood from 70 patients with chronic hepatitis C infections attended at the department of gastroenterology from University Hospital. The HCV-RNA load was performed by qRT-PCR using Sybr Green I master mix. HCV-RNA was detected in 80% (56/70) of patients in saliva and 92.85% (65/70) in plasma. The median of the viral load in the plasma was of 4.87 log10, and in saliva, it was 3.32log10, (p = 0.0005). Female patients and black patients exhibited a negative correlation between the HCV-RNA load in saliva vs. the HCV-RNA load in plasma (r = -0.3172, CI95% -0.6240 to -0.03736, p = 0.0491) and (r = -0.3141; IC95% -0.6069 to -0.05926; p = 0.0209), respectively. HCV-RNA was detected and quantified in saliva samples, and according to the quantification levels, saliva may be a possible transmission source of HCV, particularly in women and people of black ethnicity who develop chronic HCV infections.

Ocorrência de hepatites virais em profissionais da área de saúde / Occurrence of viral hepatitis among health care workers

Profissionais da área de saúde (PAS) apresentam maior risco ocupacional de aquisiçäo de determinadas doenças, principalmente as transmissíveis por sangue ou derivados, como as hepatites B e C. Entre 1986 e 1998 foi realizado levantamento dos casos de hepatites virais que ocorreram em PAS atendidos no Ambulatório de Hepatites da Disciplina de Gastroenterologia da Escola Paulista de Medicina/Unifesp. Os PAS foram divididos em três categorias: médicos, pessoal de enfermagem (enfermeiras, auxiliares, atendentes) e outros profissionais (dentistas, biomédicos e técnicos de laboratório). Dentre os 4.211 pacientes com hepatite atendidos neste período, 141 (3,3 por cento) foram em PAS, sendo 39,7 por cento no pessoal de enfermagem, 35,5 por cento em outros profissionais e 24,8 por cento em médicos. Dos 114 casos, 13,5 por cento foram de hepatite A aguda, 26,9 por cento de B aguda, 26,9 por cento de B crônica, 26,9 por cento de C crônica e 5,8 por cento de hepatite NANB. A hepatite A aguda mostrou predomínio em outros profissionais (42,1 por cento) e médicos (36,9 por cento), seguido pelo pessoal de enfermagem (21 por cento). Na hepatite B aguda, outros profissionais (36,9 por cento) e pessoal de enfermagem (34,2 por cento) foram dominantes em relaçäo a médicos (28,9 por cento). Nas hepatites crônicas B e C houve predomínio do pessoal de enfermagem (39,5 por cento e 47,4 por cento, respectivamente), seguido por outros profissionais (28,9 por cento e 39,5 por cento) e médicos (31,6 por cento e 13,1 por cento). Näo houve casos de hepatite NANB em médicos, mas somente em pessoal de enfermagem (75 por cento) e outros profissionais (25 por cento). A comparaçäo da incidência das hepatites virais entre 1986-1991 e 1992-1997 mostrou uma tendência à diminuiçäo da maioria delas. A diminuiçäo dos casos de hepatite B pode ser atribuída à maior difusäo das precauçöes universais, em decorrêencia do HIV, e também da vacinaçäo contra a hepatite B a partir de 1991. A hepatite C crônica constitui exceçäo, com aumento significativo de 1 para 36 casos diagnosticados; isso se explica pelo fato do diagnóstico de certeza da hepatite C ter se tornado disponível a partir de 1991.