Thu Jan 3, 2008 3:03 am (PST)
Hepatitis C Genotype Change After Successful Treatment Indicates Re-Infection
NEW YORK (Reuters Health) Dec 28 - Hemodialysis patients with hepatitis C
virus (HCV) infection whose HCV genotype changes after initially successful
treatment with interferon-alpha have become re-infected with a different strain
of the virus, researchers report in the January issue of the Journal of Medical
Virology. The source of the re-infection is likely the dialysis unit.
The investigators, led by Dr. Teresa C. Arrais of the Federal University of
Sao Paolo, Brazil, evaluated the course of HCV infection in 15 non-sustained
responders treated at dialysis units in Sao Paolo between 1999 and 2002.
Of 15 patients identified, all had an initial virologic response to
interferon-alpha therapy, but this response was not sustained, and all patients
were HCV-RNA positive 6 months after the end of treatment.
Four patients had acute HCV infection and 11 had chronic infections. Eight
patients had HCV subtype 1a, four patients had subtype 1b, two had subtype 3a
and one patient had HCV subtype 4a before treatment.
Five patents had a change in HCV genotype 6 months after treatment,
"suggesting nosocomial re-infection." Dr. Arrais and colleagues report.
The investigators say that "these research results suggest a possible alarming
incidence of re-infection in successfully treated patients, which should be
taken into account in the discussion to control the transmission of HCV
infection and post-treatment follow-up of hemodialysis units."
"This study emphasizes the importance of epidemiologic measures to control the
re-exposure of hemodialysis patients treated previously for HV infection," Dr.
Arrais and associates write.
J Med Virol 2008;80:80-86.


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