Transmission of hepatitis C virus (HCV) from a haemodialysis patient to a medical staff member.
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Biomedical subjects
Publications and source records attributed to F Deinhardt.
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Patients undergoing chronic hemodialysis are frequently affected by nosocomial viral infections, as indicated by the high prevalence of HBV antibodies. The question, to what extent HCV is transmitted by blood transfusions (NANB-PTH), or acquired in a nosocomial manner, is still unanswered. We therefore evaluated the HCV antibody rate of 387 sera of dialysis patients on the "Eurotransplant" waiting list. The HCV antibody reactivity ranged from 5.4 to 12.0% between different dialysis centers. In highly immunized (HLA antibody positive) long-term dialysis patients 31.3% (vs. 8.3% in non-immunized patients) were HCV antibody positive.
In a multi-center study sera from NANB-hepatitis (NANBH) patients and members of so-called HIV-risk groups (homosexuals, i.v.-drug abusers, hemophiliacs) were investigated by the recombinant-based HCV-antibody EIA, 74.4% of chronic NANBH-patients and 20% of acute NANBH patients were anti-HCV reactive, 33.3% of HIV-1-positive homosexuals, 43.5% of i.v.-drug abusers and 73.5% of hemophiliacs. The true prevalence of infection remains to be determined by a second, independent (confirmatory) test.
The occurrence of serum interferon was studied in 39 patients with acute viral hepatitis B. Antiviral activity of interferon in serum was determined by measuring the inhibition of the CPE of vesicular stomatitis virus on bovine kidney cells (MDBK). Among these patients only 5 (12.8%) had detectable serum interferon level during the first week of hospitalization. The antiviral activity of the interferon-positive sera was low (5-10 IU/ml).
The terminal carbohydrate residues of HIV I and II were detected by ferritin labeled lectins in electron microscopy. Different cell lines, which were infected with HIV I and II, expressed different terminal carbohydrate residues, which could also be detected on the viral envelope by electronmicroscopy. Especially N-Acetylgalactosamine residues were detected by Vicia villosa agglutinin only on Jurkat cells. This may have functional implications, since this lectin recognizes contrasuppressor T cells.
3289 sera of patients were tested for Parvovirus B19 specific antibodies (IgM/IgG) by ELISA for routine virological diagnostics in 1987/1988. Acute B19 infection could be confirmed in 14.5%, while 24.4% were already immune and in 61.1% antibodies could not be detected. Only 0.12% of all sera were B19-DNA positive by nucleic acid hybridisation. The highest rate of acute B19 infections could be detected in the age-group of the 6-15 year old. Infections occurred above all in the period of January to July resp. August. The most frequent clinical manifestation of acute B19 infection was exanthema (54.4%) and arthritis/arthralgia (6.5%).
We tested 638 human sera of all age groups (patients and blood donors) from the northern area of the G.D.R. and found 216 cases (33.9%) of specific parvovirus B19 antibodies (IgG) by antibody capture ELISA. The seroprevalence rose to 36.7% when the 18 parvo B19-IgM- and/or parvo B19-DNA-positive results were included. The antibody prevalence was 24.9 (27.8% resp.) in the 0-10 years group and increased continuously in the following age groups up to 61.1% (69.4% resp.) in the 51-60 years group. 50% of the newborn infants showed parvo B19-IgG-antibodies in the cord blood (of maternal origin). No sex differences in seroprevalence were observed. Parvovirus B19 is obviously very prevalent in the G.D.R. population. The main immunization occurs in the first 30-40 years of life but infection with parvo B19 at a later age is also well documented. Hence it follows that 35-45% of all G.D.R. females of reproductive age are susceptible to a parvovirus B19 infection.
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After incubation of H9 cells infected with human immunodeficiency virus (HIV) with pepstatin A at 10(-4) M for 2, 4, or 11 days, the culture medium contained significantly less HIV core antigen (p24) than controls without pepstatin A and no or only borderline activity of reverse transcriptase was detected. In addition, after pepstatin A treatment no infectious HIV at 2 or 4 days and only minimal amounts at 11 days were detectable in the culture medium.
A new assay was developed for the detection of hepatitis B virus (HBV) in human serum using amplification of a short viral DNA sequence by means of the polymerase chain reaction. As little as 0.4 fg viral DNA, corresponding to about 130 genome equivalents, per ml serum could be detected after the amplification procedure. This assay detected viral DNA in a number of patients with proven or suspected chronic HBV infection who were all negative for HBV DNA in the conventional hybridisation assay. We found HBV DNA in all of six HBeAg-positive and in three of eight HBeAg-negative HBsAg carriers, as well as in all of 11 patients with chronic liver disease with antibodies against the HBV core antigen (anti-HBc) as the sole marker for HBV infection, and in three of five apparently healthy individuals showing only anti HBc. Thus, this method is an important improvement for the diagnosis of persistent HBV infections, especially in patients where a definitive serological diagnosis is not possible.
The prevalence of 1) hepatitis C virus (HCV), an agent likely to be responsible for parenterally transmitted hepatitis non-A, non-B, 2) hepatitis B virus (HBV) and 3) human immunodeficiency virus (HIV) infection was studied in 211 patients with clotting disorders (78% of the patients had residual factor activities of less than or equal to 2%). Of these patients 71% were positive for HBV markers and 44% for HIV markers. Using a new ELISA technique, 80% were anti-HCV-positive. The prevalence of anti-HCV was greater in patients with more severe clotting disorders and was related to the total amount of replacement therapy received; the prevalence was less in older patients. Seroconversion after a single exposure to dry heat-treated factor concentrates was documented in 3 patients 3-4 months after exposure.
The prevalence of antibodies to human parvovirus B19 (anti-B19 IgG) in sera (n = 577) from Sao Tomé and Principe, Malawi and Mascarene Islands (Mauritius and Rodriguez Islands) was determined by antibody capture ELISA. The B19 prevalence was 51.5% on Sao Tomé and Principe, 58.4% in Malawi, and 55.0% on the Mauritius mainland and 2.2% on Rodriguez Island, indicating that B19 virus is highly prevalent not only in Europe, Japan and the Americas but also in the African region. Rodriguez Islands has a very low B19 prevalence.
Three different hepatitis B vaccination schedules employing injections at months 0, 1, 2, and 12, at months 0, 1, and 6, or at months 0, 1, and 12 were compared in 89 healthy young adults. Concentrations of antibodies to hepatitis B surface antigen (anti-HBs) after the third injection were dependent on the interval between the second and the third dose; geometric mean titers (GMTs) in the three groups were 53 IU/l, 5,846 IU/l, and 19,912 IU/l, respectively, when the third dose was given at month 2, 6, or 12. Whereas the anti-HBs responses to the third dose at month 6 or 12 were typical booster reactions, the kinetics after a third dose given at month 2 resembled those after only two doses but on a significantly higher level. A fourth dose given at month 12 to the individuals vaccinated at months 0, 1, and 2 led to a prompt anti-HBs response similar in height to the response in those vaccinated at months 0, 1, and 12. Thus, for achieving a high anti-HBs concentration guaranteeing its long-lasting persistence, vaccination at months 0, 1, and 12 seems to be preferable to vaccination at months 0, 1, and 6. For individuals at high risk of hepatitis B infection, vaccination at months 0, 1, 2, and 12 might be considered for obtaining an optimal early seroconversion as well as long-term protection.