If an antibody test showed postive for HBsAg, HBcAg and HBeAg, and an enzyme immunoassay showed reactivities for HcR43, NS5 and c100-3, what factors must be considered to be able to conclude that HBV and HCV were contracted from different exposures? What measures must be taken?
Testing cannot give the answers. You have to question the patient on risk factors,
Dear Sir/Madam
See these links and one file may be useful for you.
1) Comparison of a Newly Developed Automated and Quantitative ...
jcm.asm.org/content/49/12/4089.full Traduire cette page de R Kesli - 2011 - Cité 39 fois - Autres articles
HCr43 is composed of two noncontiguous coding regions of the HCV genome sequence, the 33c and core regions; c100-3 is a recombinant HCV protein within ...
2) HCVQU - Clinical: Hepatitis C Virus (HCV) RNA Detection and ...
www.mayomedicallaboratories.com/test-catalog/Clinical.../83142
Traduire cette page
Detection and confirmation of chronic HCV infection. Quantification of HCV RNA in serum of patients with chronic HCV infection (HCV antibody-positive).
3) Diagnostic tests for hepatitis C: Recent trends in electrochemical ...
www.ncbi.nlm.nih.gov › ... › Literature › PubMed Central (PMC) Traduire cette page
de CV Uliana - 2014 - Cité 8 fois - Autres articles
14 nov. 2014 - Conventional HCV diagnostic tests include virus isolation, ...... Hepatitis C Virus Encoded Antigens (Recombinant c100-3, HCr43, NS5).
4) Prevalence of hepatitis B and hepatitis C in blood donors and high risk ...
www.ncbi.nlm.nih.gov/pubmed/12370719 - Traduire cette page
de NA Haidar - 2002 - Cité 42 fois - Autres articles
The Hepatitis C screened by the same system using HCV version 3.0 [Third generation (Recombinant HCr43, c200, c100-3, NS5)]. RESULTS: The screened ...
5) J.-M. Pawlotsky. Les techniques virologiques de diagnostic et de suivi de l’hépatite B. © 2008 Elsevier Masson SAS. Tous droits réservés.
Doi : 10.1016/S0399-8320(08)73266-4
Just test the suspected sources of infection.
If the sources are untraceable, untestable or unknown the question becomes infructuous from a patient management standpoint.
Apart from the patient's clinical history which may be helpful (was the new infection associated with clinical presentation or subclinical/asymptomatic) there are several possibilities:
(i) dual infection, ie. patient acquired simultaneously HBV +HCV
(ii) patient may have been already infected either with HBV or HCV and was superinfected with a consecutive episode.
Scenario (i) is unlikely (not impossible though), however the clinical history will be characterized with two consecutive bouts of disease as the incubation period differs for the two viruses. usually HCV supresses HBV replication and hence the infectious dose for HBV will be much less and hence one may expect a much longer incubation period for HBV. The problem with HCV though is that the infection is often asymptomatic and may have gone unnoticed.
Scenario (ii) requires some prior knowledge of one of the infections; in this case one additional test may be helpful (anti-HBc IgM which is indicative of a new or more recent infection). If negative then the HBV was acquired in the past and the patient was a chronic carrier and was superinfected with HCV.
Ultimately one may never know the correct answer, however I would suggest that if a dual, simultaneous infection is suspected the source must have had some known risk factors such as IVDU for instance.
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