Graft Rejection ; Hepacivirus ; isolation & purification ; Hepatitis C, Chronic ; etiology ; immunology ; prevention & control ; Humans ; Liver Transplantation ; adverse effects ; RNA, Viral ; blood ; Risk Factors ; Secondary Prevention

To estimate the prevalence of hepatitis C virus (HCV) infection among Korean adults and to present the putative route of HCV transmission among them, serum samples from 4917 adults older than 20 years of age were tested for antibody to HCV (anti-HCV), and histories of blood transfusion and other pertinent information were obtained by self-administered questionnaires. The overall prevalence of anti-HCV was 1.7%; prevalence was 1.4% in subjects with normal levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT), 3.3% in those with slightly elevated and 5.9% in those with markedly elevated levels of the enzymes. The prevalence of anti-HCV increased with increasing age (P < 0.01), but was not associated with blood transfusion. The present study suggests that the prevalence of HCV infection was 1.4% and that the major routes of HCV transmission may be other than blood transfusion in healthy Korean adults.
Adult ; Aged ; Chi-Square Distribution ; Enzyme-Linked Immunosorbent Assay ; Female ; Hepacivirus/immunology/*isolation & purification ; Hepatitis Antibodies/*blood ; Hepatitis C/*epidemiology/immunology/transmission ; Hepatitis C Antibodies ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Prevalence ; Questionnaires ; Radioimmunoassay ; Retrospective Studies

INTRODUCTIONDried blood spot (DBS) collection is an appealing alternative to whole blood or plasma sampling, as it has technical and economic advantages over the latter.

MATERIALS AND METHODSA prospective cross-sectional study was conducted at a Malaysian tertiary referral hospital from November 2009 to March 2010. One hundred and fifty paired specimens of DBS and plasma were analysed by the standard assays for HIV Ag/Ab, HBsAg, anti-HBS and anti-HCV, separately (total 600 paired specimens). DBS sample titres were then compared to the results of plasma testing, which was used as the gold standard.

RESULTSFor the HIV Ag/Ab assay with a cut-off point of 0.35 Relative Light Units (RLUs), the sensitivity and specificity were both 100%. For the HBsAg assay, the sensitivity was 96.5% and the specificity was 97.8%, with a cut-off point of 1.72 RLUs. Sensitivity for the anti-HBs test was 74.2% and the specificity was 86.9%, using a cut-off point of 0.635 RLUs. For the anti-HCV assay, the sensitivity was 97.3% and the specificity was 100%, with a cut-off point of 0.10 RLUs.

CONCLUSIONDBS is an ideal choice to be used as a screening tool for the detection of HIV, Hepatitis B and Hepatitis C virus infections. However, different cut-off values need to be used for the validation of test positivity in DBS samples because the small amount of blood in the DBS specimens leads to lower assay titres.

Cross-Sectional Studies ; Dried Blood Spot Testing ; HIV Antibodies ; blood ; immunology ; HIV Antigens ; blood ; immunology ; HIV Infections ; diagnosis ; Hepacivirus ; isolation & purification ; Hepatitis B ; diagnosis ; Hepatitis B Antibodies ; blood ; immunology ; Hepatitis B Surface Antigens ; blood ; immunology ; Hepatitis C ; diagnosis ; Hepatitis C Antibodies ; blood ; immunology ; Hepatitis C Antigens ; blood ; immunology ; Humans ; Malaysia ; Plasma ; virology ; Prospective Studies ; Referral and Consultation ; Sensitivity and Specificity ; Specimen Handling

In order to identify the risk factors for hepatitis C virus (HCV) infections, a case-control study was conducted from September 1993 to April 1994. HCV infection was confirmed by the second generation of recombinant immunoblot assay. Sixty-four cases and 128 controls matched for age and sex with a 1:2 ratio of cases to controls were enrolled. Exposure data were obtained from all participants by self-administered questionnaire and the odds ratios of possible risk factors of HCV infection analysed. Sixty-four cases consisted of forty-two patients with chronic hepatitis, nine with cirrhosis, one with hepatocellular carcinoma, and twelve with normal liver function. History of acute hepatitis (OR 3.9) and transfusion (OR 2.4) were associated with an increased risk of HCV infection. Operation, acupuncture, endoscopy, tooth extraction, tattooing, ear piercing, needle sharing and family history of hepatitis were not associated with an increased risk of HCV infection. In conclusion, transfusion remains the major route of transmission of HCV in Korea.
Adult ; Base Sequence ; Case-Control Studies ; DNA, Viral/analysis ; Enzyme-Linked Immunosorbent Assay ; Female ; Hepacivirus/genetics/immunology/isolation & purification ; Hepatitis C/*epidemiology/immunology/virology ; Hepatitis C Antibodies/blood ; Human ; Male ; Middle Age ; Molecular Sequence Data ; Predictive Value of Tests ; Risk Factors ; Support, Non-U.S. Gov't