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Failure to diagnose recent hepatitis C virus infections in London injecting drug users.
J Med Virol 2004; 73(4):548-53JM

Abstract

Hepatitis C virus (HCV) infection results in chronic liver disease in a substantial proportion of those infected. Most new cases of HCV infection in the UK are associated with intravenous drug use. It is important to identify these infections because of the implications for the future health of the individuals concerned and for the control of further spread of infection. However, as hepatitis C infection is characterised by a relatively long asymptomatic period of seronegative viraemia, a laboratory diagnostic protocol that does not test HCV seronegative samples for the presence of HCV RNA may wrongly designate HCV viraemic seronegative individuals as uninfected. Amongst 424 injecting drug users whose serum was sent to our diagnostic laboratory for "HCV screening" over a 14-month period, the prevalence of HCV seropositivity was 48.4%. We retrospectively identified seven individuals for whom there was evidence of recent acquisition of HCV infection. Three of these infections were identified using our routine diagnostic protocol: testing for the presence of HCV-specific antibody and performing HCV RNA testing only on seropositive and seroindeterminate specimens. However, four cases were only identified by HCV RNA testing of HCV seronegative serum. On the basis of these observations, we estimate the incidence of HCV infection amongst London injecting drug users as being 14.3 per 100 person-years. We advocate that all HCV seronegative blood samples obtained from injecting drug users should be tested for the presence of HCV RNA, and suggest that this could be done efficiently by nucleic acid testing the specimens in small pools. .

Authors+Show Affiliations

Centre of Virology, University College London, London, United Kingdom.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15221898

Citation

Aarons, Emma, et al. "Failure to Diagnose Recent Hepatitis C Virus Infections in London Injecting Drug Users." Journal of Medical Virology, vol. 73, no. 4, 2004, pp. 548-53.
Aarons E, Grant P, Soldan K, et al. Failure to diagnose recent hepatitis C virus infections in London injecting drug users. J Med Virol. 2004;73(4):548-53.
Aarons, E., Grant, P., Soldan, K., Luton, P., Tang, J., & Tedder, R. (2004). Failure to diagnose recent hepatitis C virus infections in London injecting drug users. Journal of Medical Virology, 73(4), pp. 548-53.
Aarons E, et al. Failure to Diagnose Recent Hepatitis C Virus Infections in London Injecting Drug Users. J Med Virol. 2004;73(4):548-53. PubMed PMID: 15221898.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Failure to diagnose recent hepatitis C virus infections in London injecting drug users. AU - Aarons,Emma, AU - Grant,Paul, AU - Soldan,Kate, AU - Luton,Pete, AU - Tang,Julian, AU - Tedder,Richard, PY - 2004/6/29/pubmed PY - 2004/8/13/medline PY - 2004/6/29/entrez SP - 548 EP - 53 JF - Journal of medical virology JO - J. Med. Virol. VL - 73 IS - 4 N2 - Hepatitis C virus (HCV) infection results in chronic liver disease in a substantial proportion of those infected. Most new cases of HCV infection in the UK are associated with intravenous drug use. It is important to identify these infections because of the implications for the future health of the individuals concerned and for the control of further spread of infection. However, as hepatitis C infection is characterised by a relatively long asymptomatic period of seronegative viraemia, a laboratory diagnostic protocol that does not test HCV seronegative samples for the presence of HCV RNA may wrongly designate HCV viraemic seronegative individuals as uninfected. Amongst 424 injecting drug users whose serum was sent to our diagnostic laboratory for "HCV screening" over a 14-month period, the prevalence of HCV seropositivity was 48.4%. We retrospectively identified seven individuals for whom there was evidence of recent acquisition of HCV infection. Three of these infections were identified using our routine diagnostic protocol: testing for the presence of HCV-specific antibody and performing HCV RNA testing only on seropositive and seroindeterminate specimens. However, four cases were only identified by HCV RNA testing of HCV seronegative serum. On the basis of these observations, we estimate the incidence of HCV infection amongst London injecting drug users as being 14.3 per 100 person-years. We advocate that all HCV seronegative blood samples obtained from injecting drug users should be tested for the presence of HCV RNA, and suggest that this could be done efficiently by nucleic acid testing the specimens in small pools. . SN - 0146-6615 UR - https://www.unboundmedicine.com/medline/citation/15221898/Failure_to_diagnose_recent_hepatitis_C_virus_infections_in_London_injecting_drug_users_ L2 - https://doi.org/10.1002/jmv.20124 DB - PRIME DP - Unbound Medicine ER -