Hepatitis C virus genotypes in the liver and serum of patients with chronic hepatitis C

Absence of HCV viral recombination following superinfection

We sought evidence of viral recombination in five recently hepatitis C virus (HCV) infected young injection drug users who became superinfected with a distinguishable strain of HCV. The entire open reading frame of plasma HCV genomes was reverse transcribed, polymerase chain reaction amplified in two fragments, and directly sequenced. In two cases of same subtype (1a > 1a) superinfections the initial and later strains were both sequenced and compared for evidence of recombination. In three cases of superinfection with strains of different genotype/subtype (3a > 1a, 1a > 3a, 1b > 1a), the later time point HCV genomes were sequenced and compared with representative genomes of the initial genotype/subtype. No evidence of intra- or inter-genotype/subtype recombination was detected using six different programs for detecting recombination. We conclude that the generation of viable recombinant HCV genomes able to dominate in the viral quasispecies is a rare event.

A cluster of hepatitis C virus infections associated with ozone-enriched transfusion of autologous blood in Rome, Italy

OBJECTIVE

To describe an outbreak of hepatitis C virus (HCV).

DESIGN

Retrospective cohort study.

SETTING

Outpatient department of a hospital in Rome, Italy.

PATIENTS

All 42 patients exposed to ozone therapy by autohemotherapy or intramuscular injection from January to June 2001.

METHODS

Epidemiologic investigation, serologic analysis, and virus genotyping.

RESULTS

Thirty-one (74%) of the patients agreed to participate in the study. Three (9.7%) had symptoms of HCV infection. This incidence rate was higher than the rate of 1.4 per 100,000 per year in the regional population. Six patients were positive for HCV antibodies and HCV RNA for a prevalence rate of 19.4%, which was much higher than the estimate of 0.9% in the population. Virus genotype 1b was found in two case-patients (one symptomatic) and 2c in four case-patients (two symptomatic), one of whom was known to have an HCV infection since 1986 and could have been the source of infection. The infected patients were all being exposed to ozone-enriched transfusions of autologous blood. Although the specific mode of transmission between patients was not detected, transmission probably occurred during one of the three busiest therapeutic sessions in the 6-month period.

CONCLUSIONS

Transmission of HCV infection may occur during medical procedures with limited bleeding. Standard precautions must be applied in any healthcare setting; restricting the number of individuals treated during each therapeutic session could be an effective way of avoiding accidental transmission of infection.