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Injection Drug Use Facilitates Hepatitis C Virus Infection of Peripheral Blood
Mononuclear Cells
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Clinical Infectious Diseases 2002;35:236-239
Massimo Resti, Chiara Azzari, Maria Moriondo, Letizia Betti, Idanna Sforzi, Elio Novembre, and Alberto Vierucci; Department of Pediatrics, University of Florence, and Pediatric Hospital A. Meyer, Florence, Italy
Abstract: Infection of peripheral blood mononuclear cells (PBMCs) with hepatitis C virus (HCV) has been demonstrated and has been found to play a role in relapse of HCV disease and vertical transmission of HCV. Injection drug use is thought to impair function of the immune system and induce tolerance to viruses; therefore, HCV infection of PBMCs could be more likely to occur in injection drug users (IDUs) with HCV infection. Of 108 women who tested negative for human immunodeficiency virus type 1 and positive for HCV RNA, 51 had a history of injection drug use and 57 had no known risk factor for HCV infection. HCV infection was found, by nested reverse-transcription polymerase chain reaction analysis, in the PBMCs of 33 IDUs and of 13 non-IDUs (P = .00003). No correlation was found between infection of the PBMCs and HCV genotype or virus load. Route of transmission and viral factors, as well as immunologic dysfunction, may play a role in viral tropism.
Comparison of Methodologies for Quantification of Hepatitis C Virus (HCV) RNA in Patients Coinfected with HCV and Human Immunodeficiency Virus
Clinical Infectious Diseases 2002;35:482-487
Kenneth E. Sherman,1 Susan D. Rouster,1 and Paul S. Horn2
Department of Medicine, Division of Digestive Diseases, University of Cincinnati College of Medicine, and 2Department of Mathematical
Sciences, University of Cincinnati, Ohio
Quantification of hepatitis C virus (HCV) RNA is important in the assessment of
HCV-associated liver disease in patients coinfected with HCV and human
immunodeficiency virus (HIV). To investigate whether the standard integrity of
competing test methodologies might be compromised by higher HCV titers in coinfected patients, 2 technologies (a polymerase chain reactionbased assay [COBAS Amplicor 2.0 assay; Roche Diagnostics] and a branched-chain DNA assay [Versant 3.0; Bayer]) were evaluated by testing paired serum samples from 68 coinfected patients and 137 HCV-monoinfected patients. Although the correlation was highly significant (r = 0.81; P < .001), HCV RNA titers expressed in international units per milliliter could not be standardized; statistically significant differences were observed in all quartiles. Significant variability (P < .0007) was observed in the classification of patients as having a high versus a low virus titer (cutoff, 800,000 IU/mL), which suggests that standardization in international units has low efficacy among coinfected patients. Clinicians should note that test variability precludes direct comparability of HCV RNA
titers, particularly in coinfected patients with high titers.
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