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Reuters Health Information (2007-12-28): Hepatitis C genotype change after successful treatment indicates re-infection


Hepatitis C genotype change after successful treatment indicates re-infection

Last Updated: 2007-12-28 15:11:23 -0400 (Reuters Health)

NEW YORK (Reuters Health) - 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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