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2.
Rev Sci Instrum ; 94(4)2023 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38081228

RESUMEN

We describe an optical method to directly measure the position-dependent thermal diffusivity of reflective single crystal samples across a broad range of temperatures for condensed matter physics research. Two laser beams are used, one as a source to locally modulate the sample temperature, and the other as a probe of sample reflectivity, which is a function of the modulated temperature. Thermal diffusivity is obtained from the phase delay between source and probe signals. We combine this technique with a microscope setup in an optical cryostat, in which the sample is placed on a three-axis piezo-stage, allowing for spatially resolved measurements. Furthermore, we demonstrate experimentally and mathematically that isotropic in-plane diffusivity can be obtained when overlapping the two laser beams instead of separating them in the traditional way, which further enhances the spatial resolution to a micron scale, especially valuable when studying inhomogeneous or multidomain samples. We discuss in detail the experimental conditions under which this technique is valuable and demonstrate its performance on two stoichiometric bilayer ruthenates: Sr3Ru2O7 and Ca3Ru2O7. The spatial resolution allowed us to study the diffusivity in single domains of the latter, and we uncovered a temperature-dependent in-plane diffusivity anisotropy. Finally, we used the enhanced spatial resolution enabled by overlapping the two beams to measure the temperature-dependent diffusivity of Ti-doped Ca3Ru2O7, which exhibits a metal-insulator transition. We observed large variations of transition temperature over the same sample, originating from doping inhomogeneity and pointing to the power of spatially resolved techniques in accessing inherent properties.

3.
Gut ; 49(4): 565-76, 2001 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-11559656

RESUMEN

BACKGROUND: Primary biliary cirrhosis (PBC) is an autoimmune disease in which the pathogenesis of progressive liver injury is poorly understood. AIM: To provide novel insights into the pathogenesis of PBC related liver injury using cDNA array analysis, which simultaneously examines expression of many genes. METHODS: Utilising cDNA arrays of 874 genes, PBC was compared with primary sclerosing cholangitis (PSC) associated cirrhosis and non-diseased liver. Differential expression of 10 genes was confirmed by real time quantitative reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS: Array analysis identified many differentially expressed genes that are important in inflammation, fibrosis, proliferation, signalling, apoptosis, and oxidative stress. PBC was associated with increased expression of both Th1 and Th2 type molecules of the immune response. Fibrosis related gene expression featured upregulation of connective tissue growth factor and transforming growth factor beta3. Many more apoptosis associated molecules exhibited increased expression, consistent with apoptosis being a more active and regulated process, in PSC associated cirrhosis than in PBC. Increased expression of many genes of the Wnt and notch pathways implicated these highly conserved and linked pathways in PBC pathogenesis. The observed increases in expression of c-jun, c-myc, and c-fos related antigen 1 are consistent with increased Wnt pathway activity in PBC. Differential expression of four components of the Wnt pathway, Wnt-5a, Wnt-13, FRITZ, and beta-catenin, was confirmed by quantitative RT-PCR. CONCLUSION: Many genes implicated in intrahepatic inflammation, fibrosis, and regeneration were upregulated in PBC cirrhosis. In particular, increased expression of a number of Drosophila homologues was seen in PBC.


Asunto(s)
Enfermedades Autoinmunes/genética , Perfilación de la Expresión Génica , Cirrosis Hepática Biliar/genética , Análisis de Secuencia por Matrices de Oligonucleótidos , Apoptosis/fisiología , Enfermedades Autoinmunes/patología , Estudios de Casos y Controles , Comunicación Celular/fisiología , Colangitis Esclerosante/genética , Colangitis Esclerosante/patología , Humanos , Cirrosis Hepática Biliar/patología , Estrés Oxidativo/fisiología , Análisis de Regresión , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Estadísticas no Paramétricas , Células TH1/metabolismo , Células Th2/metabolismo , Regulación hacia Arriba
4.
Immunol Cell Biol ; 79(3): 213-21, 2001 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-11380673

RESUMEN

Real-time quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) is the method of choice for rapid and reproducible measurements of cytokine or growth factor expression in small samples. Fluorescence detection methods for monitoring real-time PCR include fluorogenic probes labelled with reporter and quencher dyes, such as Taqman probes or Molecular Beacons and the dsDNA-binding dye SYBR Green I. Fluorogenic (Taqman) probes for a range of human and rat cytokines and growth factors were tested for sensitivity and compared with an assay for SYBR Green I quantification using real-time fluorescence monitoring (PE Applied Biosystems Model 7700 sequence detector). SYBR Green I detection involved analysis of the melting temperature of the PCR product and measurement of fluorescence at the optimum temperature. Fluorogenic probes provided sensitive and reproducible detection of targets that ranged from low (<10 copies/reaction) to high (>107 copies/ reaction) expression. SYBR Green I gave reproducible quantification when the target gene was expressed at moderate to high levels (> or =1000 copies/reaction), but did not give consistently reproducible quantification when the target gene was expressed at low levels. Although optimization of melting temperature improved the specificity of SYBR Green I detection, in our hands it did not equal the reproducible sensitivity and specificity of fluorogenic probes. The latter method is the first choice for measurement of low-level gene expression, although SYBR Green I is a simple and reproducible means to quantify genes that are expressed at moderate to high levels.


Asunto(s)
Citocinas/genética , Colorantes Fluorescentes/metabolismo , Péptidos y Proteínas de Señalización Intercelular , Compuestos Orgánicos , ARN Mensajero/metabolismo , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Animales , Benzotiazoles , Tampones (Química) , Citocinas/metabolismo , Diaminas , Gliceraldehído-3-Fosfato Deshidrogenasas/genética , Gliceraldehído-3-Fosfato Deshidrogenasas/metabolismo , Humanos , Interferón gamma/genética , Interferón gamma/metabolismo , Proteínas/genética , Proteínas/metabolismo , Quinolinas , ARN Mensajero/genética , Ratas , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
5.
Immunol Rev ; 174: 172-91, 2000 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-10807516

RESUMEN

The hallmarks of chronic liver diseases are chronic inflammation, cellular damage, regeneration and fibrosis. An appreciation of intrahepatic molecular expression patterns in normal and diseased liver provides clues for understanding pathogenic pathways whilst studies of the structure and function of molecules implicated in liver disease provide insights into their potential as therapeutic targets. We have examined the expression, function, molecular structure and structure-function relationships of type IV dipeptidyl aminopeptidases. In particular, the roles of CD26/DPPIV in T-cell proliferation and chemotaxis and of fibroblast activation protein in human cirrhosis are discussed. We have investigated the pathogenesis of liver disease by characterising patterns of cytokine and growth factor expression in experimental and human cirrhosis. We have quite recently expanded this approach to use differential gene expression analyses to elucidate overall pathways of gene activation and suppression in human cirrhosis. In addition, our detailed molecular and cellular studies of the mechanisms of spontaneous liver transplant tolerance have generated novel insights into this process. This review touches on these diverse aspects of liver function and disease.


Asunto(s)
Antígenos de Neoplasias , Biomarcadores de Tumor , Dipeptidil Peptidasa 4/fisiología , Hepatitis/enzimología , Cirrosis Hepática/enzimología , Hepatopatías/enzimología , Trasplante de Hígado , Subgrupos de Linfocitos T/enzimología , Adenosina Desaminasa/metabolismo , Animales , Apoptosis , Sitios de Unión , Diferenciación Celular , Citocinas/biosíntesis , Citocinas/genética , Dipeptidil Peptidasa 4/química , Endopeptidasas , Gelatinasas , Perfilación de la Expresión Génica , Regulación de la Expresión Génica , Supervivencia de Injerto , Sustancias de Crecimiento/biosíntesis , Sustancias de Crecimiento/genética , Sustancias de Crecimiento/fisiología , Hepatitis/inmunología , Hepatitis/patología , Humanos , Tolerancia Inmunológica , Cirrosis Hepática/inmunología , Cirrosis Hepática/patología , Hepatopatías/inmunología , Hepatopatías/patología , Trasplante de Hígado/inmunología , Activación de Linfocitos , Proteínas de la Membrana , Modelos Moleculares , Ratas , Serina Endopeptidasas/fisiología , Relación Estructura-Actividad , Técnica de Sustracción , Subgrupos de Linfocitos T/inmunología , Subgrupos de Linfocitos T/patología , Células TH1/enzimología , Células TH1/inmunología , Células Th2/enzimología , Células Th2/inmunología , Activación Transcripcional
6.
Gut ; 46(2): 260-9, 2000 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-10644323

RESUMEN

BACKGROUND: Upregulation of Th1 associated intrahepatic cytokines in chronic hepatitis C virus (HCV) infection should lead to a significant non-specific cellular immune response, a prerequisite for viral clearance. However, to date, the role of this non-specific response in HCV has been understudied. AIMS: To analyse the intrahepatic macrophage activity in chronic HCV infection by immunostaining and by quantitation of cytokine mRNA. METHODS: HCV positive liver tissues (chronic hepatitis, n=10; cirrhosis, n=5) were immunostained for CD68, MAC387, and semiquantitated by polymerase chain reaction for intrahepatic cytokine mRNAs (interferon gamma (IFNgamma), interleukin 1beta (IL-1beta), IL-6, IL-18, tumour necrosis factor alpha (TNFalpha), and macrophage inflammatory protein 1beta (MIP1beta)). HCV negative normal liver tissues (for cytokines, n=6; for immunostaining, n=5) were included as controls. RESULTS: MAC387(+) cells were focally increased in areas of erosion at the limiting plate while lobular staining was minimal. CD68(+) staining was diffuse in both portal (increased in HCV) and lobular areas. The portal tract (mean) density of CD68(+) and MAC387(+) cells was significantly increased in patients with HCV compared with normal tissue. IFNgamma and IL-18 mRNA levels were highly correlated and significantly upregulated in chronic hepatitis and cirrhotic tissue versus controls. TNFalpha mRNA was upregulated in chronic hepatitis without cirrhosis, while IL-6 mRNA was significantly downregulated. IL-1beta, IL-6, and MIP1beta mRNA levels were significantly correlated with portal tract MAC387(+) cell density. CONCLUSIONS: The significant upregulation of IFNgamma and IL-18 mRNA and significant correlations between IFNgamma and other proinflammatory cytokines, suggest a Th1/cell mediated intrahepatic immune response in chronic HCV infection. However, further clarification of the cellular sources of these cytokines is required.


Asunto(s)
Antígenos CD/inmunología , Antígenos de Diferenciación Mielomonocítica/inmunología , Hepatitis C Crónica/inmunología , Interleucina-18/genética , Hígado/inmunología , Adulto , Biomarcadores/análisis , Quimiocina CCL4 , Femenino , Humanos , Interferón gamma/genética , Interleucina-1/genética , Interleucina-6/genética , Proteínas Inflamatorias de Macrófagos/genética , Macrófagos/inmunología , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Estadísticas no Paramétricas , Células TH1/inmunología , Factor de Necrosis Tumoral alfa/genética
7.
J Gastroenterol Hepatol ; 12(6): 453-9, 1997 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-9195404

RESUMEN

During the study period, 63 patients with hepatitis C virus (HCV) cirrhosis were referred to our unit for liver transplantation. All cases referred and transplanted were retrospectively examined. Eighty-six per cent of referred patients were male, 35% consumed alcohol in the harmful/hazardous range, 13% were infected with hepatitis B and 7% had hepatocellular carcinoma. Patients with sporadic infection were more likely to be born outside Australia and were an average of 10 years older than those with HCV acquired via intravenous drug use (P < 0.001). However, patients were an average of 12 years younger at referral if they consumed harmful amounts of alcohol than if they abstained (P = 0.002). We examined the impact of HCV on the outcome of 28 patients who underwent liver transplantation (mean follow up 25 months; range 3-76 months). The use of OKT3, HCV genotype and hepatitis B status were examined for their effect on HCV-related graft dysfunction. Three year survival was 84%, equivalent to a control group. Chronic HCV-related graft dysfunction occurred in 15 (56%) patients, of whom 10 had an asymptomatic elevation in serum amino transferase, two had cholestatic hepatitis and three had severe hepatitis C that progressed onto chronic rejection. Hepatitis C virus genotype 1b tended to be associated with HCV graft dysfunction (5/6 type 1b vs 10/16 in non-type 1b). In conclusion, HCV is an increasingly common indication for liver transplantation. Alcohol and hepatitis B were frequently occurring cofactors in the referral cohort. Most patients referred were male, although the reason why is not clear. Transplantation offers a good medium-term outcome, despite the high incidence of HCV-associated graft dysfunction.


Asunto(s)
Hepatitis C/complicaciones , Cirrosis Hepática/cirugía , Trasplante de Hígado , Adulto , Consumo de Bebidas Alcohólicas/efectos adversos , Australia/epidemiología , Estudios de Cohortes , Femenino , Genotipo , Hepatitis B/complicaciones , Humanos , Cirrosis Hepática/epidemiología , Cirrosis Hepática/genética , Masculino , Persona de Mediana Edad , Recurrencia , Derivación y Consulta , Estudios Retrospectivos , Factores Sexuales , Tasa de Supervivencia , Resultado del Tratamiento
8.
Immunol Cell Biol ; 75(2): 142-7, 1997 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-9107566

RESUMEN

Reverse transcriptase-PCR (RT-PCR) amplification of mRNA is often the only technique able to detect expression of cytokine mRNA in small samples. The aim of this work was to investigate the utility of a non-competitive RT-PCR which used external standards to quantitate TNF-alpha mRNA in liver biopsy specimens from liver transplant patients. It involved removal of aliquots from the PCR reaction at successive cycles, followed by dot-blotting of the samples onto nylon membrane and hybridization with a radioactively-labelled internal probe. Phosphorimage analysis of the labelled membranes allowed quantitation of the relative amount of PCR product at successive cycles. Plots of log(counts) versus cycle number showed straight lines in the exponential phase of amplification. The slopes of these lines showed the efficiency of amplification, which ranged from 76 to 87% for liver biopsy samples. Estimation of liver biopsy levels of TNF-alpha in two separate PCR amplifications showed low inter-assay variability (r2 = 0.98). Comparison of two separate cDNA syntheses also showed good correlation (r2 = 0.81, P < 0.0001), although not as good as for the PCR alone. This shows that variation in efficiency of cDNA synthesis is likely to contribute as much or more to variability of the analysis as variations in PCR amplification.


Asunto(s)
Reacción en Cadena de la Polimerasa/métodos , ARN Mensajero/metabolismo , Factor de Necrosis Tumoral alfa/metabolismo , Biomarcadores , Biopsia , Cartilla de ADN , Humanos , Hígado/metabolismo , Hígado/patología , ADN Polimerasa Dirigida por ARN/genética , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Factor de Necrosis Tumoral alfa/genética
9.
J Gastroenterol Hepatol ; 12(2): 182-7, 1997 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-9083922

RESUMEN

The aim of the present study was to characterize hepatitis C virus (HCV) genotypes using the INNO-LiPA HCV line probe assay and direct sequencing from three different HCV-RNA-positive (serum) groups: (i) blood donors (n = 59); (ii) haemophiliacs (n = 43); and (iii) patients undergoing liver transplantation (n = 26). Of 128 HCV-RNA-positive samples, 74 (58%) were genotype 1. Of these, 41 were genotype 1a, 32 were genotype 1b and one was genotype 1 indeterminate. Of the remaining 54 samples, seven (5%) were genotype 2a, two (2%) were genotype 2b, 26 (20%) were genotype 3a, three (2%) were genotype 4a, while 16 (12.5%) were of a mixed genotype. There was no significant difference between the three groups with regard to the prevalence of any specific genotype. However, in blood donors and haemophiliac patients there was a statistically significant difference in the occurrence of genotype 3a in patients with elevated alanine aminotransferase (ALT) levels (30.3%) compared with those patients with persistently normal ALT levels (5.6%; P = 0.004; chi 2). Genotype 3a was also uncommon in liver transplant patients (one of 14) with "sporadic' HCV infection. Genotype 4a was detected only in liver transplant patients. These patients had originated from Egypt (n = 1), Italy (n = 1) and Romania (n = 1).


Asunto(s)
Donantes de Sangre , Hemofilia A/virología , Hepacivirus/genética , Cirrosis Hepática/cirugía , Cirrosis Hepática/virología , Trasplante de Hígado , Adulto , Alanina Transaminasa/sangre , Estudios de Cohortes , Femenino , Genotipo , Hemofilia A/sangre , Humanos , Masculino , Persona de Mediana Edad
10.
Hepatology ; 24(4): 759-65, 1996 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-8855173

RESUMEN

An imbalance between T helper cell (Th)1 and Th2-like cytokines has been described in several chronic infectious diseases. We therefore analyzed the intrahepatic messenger RNA (mRNA) expression of Th1-like (interleukin [IL]-2, interferon [IFN]-gamma) and Th2-like (IL-4, IL-10) cytokines in chronic hepatitis C patients (n = 17) and controls (n = 6) and correlated the results with liver histology and intrahepatic viral load. Intrahepatic cytokine mRNA and hepatitis C virus (HCV) RNA were quantitatively assessed by polymerase chain reaction (PCR) using a dot-blot hybridization technique. Liver biopsy specimens were histologically graded using the Scheuer Score. IFN-gamma and IL-2 mRNA expression were significantly upregulated in chronic HCV vs. controls (P < .002, P < .04, respectively). Both correlated significantly with histological fibrosis and portal tract inflammation. In contrast, the expression of IL-10 mRNA was decreased in cirrhosis and chronic HCV compared with controls (P < .02, P < .0001, respectively). IL-4 mRNA was detected inconsistently at low levels in all groups. Intrahepatic viral load did not correlate with either cytokine expression or tissue injury. In conclusion, the progressive liver injury seen in chronic HCV is associated with the upregulation of intrahepatic Th1-like cytokines and the downregulation of IL-10, a Th2-like cytokine. These results suggest a role for delayed-type hypersensitivity immune reactions in HCV related liver injury.


Asunto(s)
Hepatitis C/metabolismo , Hepatitis Crónica/metabolismo , Interferón gamma/metabolismo , Interleucina-10/metabolismo , Interleucina-2/metabolismo , Adulto , Anciano , Alanina Transaminasa/metabolismo , Biomarcadores , Progresión de la Enfermedad , Regulación hacia Abajo , Femenino , Fructosa-Bifosfato Aldolasa/metabolismo , Hepatitis C/patología , Hepatitis Crónica/patología , Humanos , Interleucina-4/metabolismo , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , ARN Mensajero/metabolismo , Reproducibilidad de los Resultados , Regulación hacia Arriba
11.
Hepatology ; 23(4): 676-87, 1996 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-8666317

RESUMEN

The balance between a direct cytopathic effect by hepatitis C virus (HCV) and immune-mediated injury remains unclear. This report aims to test the following hypotheses: (1) that intrahepatic HCV load would correlate with the degree of liver injury; (2) that interferon alfa (IFN-alpha) would decrease intrahepatic HCV-RNA levels. Liver tissues (n = 56) were obtained from 47 patients with chronic HCV (9 before and after IFN-alpha therapy). Total RNA was isolated and quantitated for specific HCV RNA by dot-blot polymerase chain reaction (DB-PCR) using a standard curve created from synthetic HCV RNA of known titer to calculate actual RNA levels. A multivariate analysis was undertaken to determine the relationship of intrahepatic HCV-RNA levels with risk factors, length of HCV exposure, and histological injury scores. The confounding effect of HCV genotype was examined by direct sequencing of the NS5b region. Liver HCV RNA ranged from 10(2) to 3.1 x 10(7) molecules per microgram total liver RNA. The multiple regression analysis showed no effect of length of HCV exposure, risk factors, degree of bile duct damage, steatosis, or total Scheuer or Knodell score on RNA levels. No significant confounding effect of HCV genotype on the degree of liver injury was observed. However, genotype 1b had a significantly higher mean intrahepatic HCV-RNA load compared with the other genotypes detected. In the 9 patients who received IFN-alpha, treatment, 7 had no detectable HCV after treatment. This was associated with a significant decrease in intrahepatic HCV-RNA levels (7.57 +/- 2.53 X 10(5) to 1.82 +/- 1.80 x 10(3) molecules per microgram total liver RNA +/- SEM, n = 9, P = .0005). These results do not directly support our hypothesis that increased intrahepatic HCV load is associated with more severe liver injury. Intrahepatic viral load appears to be significantly increased in patients with genotype lb. IFN-alpha treatment does significantly lower intrahepatic HCV load.


Asunto(s)
Hepacivirus/genética , Hepatitis C/virología , Hígado/virología , ARN Viral/análisis , Adulto , Anciano , Alanina Transaminasa/sangre , Secuencia de Bases , Enfermedad Crónica , Femenino , Hepatitis C/patología , Hepatitis C/terapia , Humanos , Interferón-alfa/uso terapéutico , Hígado/patología , Masculino , Persona de Mediana Edad , Datos de Secuencia Molecular , Reacción en Cadena de la Polimerasa
13.
Hepatology ; 18(3): 485-90, 1993 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-7689526

RESUMEN

Approximately 90% of subjects with chronic hepatitis resulting from hepatitis C virus infection have hepatitis C virus RNA in serum. However, the prevalence of hepatitis C virus RNA in serum from subjects with hepatitis C virus antibody associated with persistent normal liver biochemical values is unclear. Do these subjects have resolved or continuing infection with hepatitis C virus? The aim of this study was to examine whether subjects with hepatitis C virus antibody but normal ALT levels had evidence of ongoing infection. Our study population was divided into four groups. Groups 1, 2 and 3 comprised hepatitis C virus antibody-positive volunteer blood donors. Group 1 was made up of subjects found to be hepatitis C virus antibody-positive on enzyme-linked immunosorbent assay with persistent abnormal ALT levels (59 donors: 53 positive on recombinant immunoblot assay and 6 indeterminate). Group 2 members were hepatitis C virus antibody positive, with persistent normal ALT levels (50 donors: 39 positive on recombinant immunoblot assay and 11 indeterminate). Group 3 members were hepatitis C virus seropositive but negative on second-generation recombinant immunoblot assay (n = 48). Twenty patients (not blood donors) with chronic liver disease who were anti-hepatitis C virus seronegative were used as controls (group 4). Serum samples from all four groups were assayed for hepatitis C virus RNA on reverse transcription and a 40-cycle polymerase chain reaction with a combination of primers from the highly conserved 5'-noncoding and less-conserved third and fourth nonstructural regions. All assays were confirmed on hybridization with an internal probe.(ABSTRACT TRUNCATED AT 250 WORDS)


Asunto(s)
Donantes de Sangre , ADN Viral/sangre , Hepacivirus/aislamiento & purificación , Anticuerpos Antihepatitis/sangre , Hepatitis C/diagnóstico , Adulto , Alanina Transaminasa/sangre , Secuencia de Bases , Secuencia Conservada , ADN Viral/genética , ADN Viral/aislamiento & purificación , Femenino , Genoma Viral , Hepacivirus/genética , Hepatitis C/sangre , Anticuerpos contra la Hepatitis C , Humanos , Masculino , Datos de Secuencia Molecular , Oligodesoxirribonucleótidos , Reacción en Cadena de la Polimerasa/métodos
15.
Med J Aust ; 157(4): 231-3, 1992 Aug 17.
Artículo en Inglés | MEDLINE | ID: mdl-1279365

RESUMEN

OBJECTIVES: (i) To assess evidence of liver disease in 50 consecutive volunteer blood donors who were anti-hepatitis C virus (anti-HCV) antibody positive and who were referred to one hepatologist; (ii) to assay for viral RNA in serum in these patients. SETTING: Royal Prince Alfred Hospital, a teaching hospital of the University of Sydney. PATIENTS: Fifty people who were detected by the NSW Red Cross Blood Transfusion Service to be anti-HCV antibody positive and to have a positive result on recombinant immunoblot assay (RIBA) were assessed by one hepatologist for symptoms, signs and biochemical evidence of hepatic dysfunction. These patients were consecutive referrals from this source. Sixteen of these patients also consented to liver biopsy assessment. All patients had serum assayed for viral RNA by polymerase chain reaction with a combination of 3' and 5' primers. RESULTS: The 50 blood donors consisted of 28 men and 22 women, with a mean age of 34.5 years. Forty-six patients were asymptomatic. Only six had a past history of hepatitis while 14 had minor signs of chronic liver disease. In 28, injecting drug use was thought the most likely source of exposure to HCV. The minimal mean time since exposure to HCV in these patients was 8.8 +/- 5.2 years. Eight patients had received a blood transfusion at a mean time of 15.0 +/- 9.8 years from the time of consultation. The mean maximum level of alanine aminotransferase (ALT) in all 50 patients was 102.8 U/L. Five patients had persistently normal ALT levels; another 22 had at least one normal ALT level. Liver biopsies indicated chronic persistent hepatitis in 11 patients, mild chronic active hepatitis in three patients and more severe chronic active hepatitis in one. One patient had cirrhosis on biopsy. Forty-two patients had viral RNA detected in serum. CONCLUSION: Chronic infection with HCV in blood donors was invariably asymptomatic; 78% of patients had no signs of chronic liver disease and 68% had a maximum hepatic transaminase level of less than 100 U/L. Although severe liver disease was seen in two of 16 biopsies, the majority of these patients have mild liver disease despite a mean of about 10 years since exposure to the virus. Eighty-four per cent of patients had evidence of viral RNA in serum.


Asunto(s)
Donantes de Sangre/estadística & datos numéricos , Hepacivirus/genética , Hepatitis C/diagnóstico , ARN Viral/análisis , Adulto , Alanina Transaminasa/sangre , Secuencia de Bases , Transfusión Sanguínea , Femenino , Hepacivirus/inmunología , Anticuerpos Antihepatitis/análisis , Hepatitis C/inmunología , Hepatitis C/transmisión , Anticuerpos contra la Hepatitis C , Hepatitis Crónica/diagnóstico , Humanos , Immunoblotting , Incidencia , Masculino , Datos de Secuencia Molecular , Reacción en Cadena de la Polimerasa , Abuso de Sustancias por Vía Intravenosa/complicaciones
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