Dynamics of viremia in early hepatitis C virus infection
Dynamics of viremia in early hepatitis C virus infection
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DOI：
10.1111/j.1537-2995.2005.04390.x
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发表时间：
2005-06-01
期刊：
影响因子：
2.9
通讯作者：
Busch, MP
中科院分区：
文献类型：
--
作者：
Glynn, SA;Wright, DJ;Busch, MP
背景资料：丙型肝炎病毒（HCV）感染早期的病毒动力学特征对于进一步了解病毒的发病机制以及通过输血或其他途径在急性感染中继发传播的可能性非常重要。通过核酸扩增技术（NAT）筛查，77名HCV RNA阴性转为HCV RNA阳性的源血浆供体给予的连续单位，512-结果：在HCV感染的上升期，HCV病毒载量每10.8小时增加一倍（95%可信区间[CI]，9.9-12.0）。在50个面板中的37个面板中，在斜升阶段之前观察到间歇性病毒血症，最早可检测到的病毒血症出血发生在估计斜升开始之前63天。平台期或高滴度病毒血症期间，发生之间的斜坡上升和血清转换估计持续56.3天（95%CI，44.8-67.8）。结论：间歇性低水平HCV病毒血症可以发生多达2个月前的病毒载量和高滴度的平台期病毒血症，通常在血清转换。动物接种研究正在进行中，以评估低水平病毒血症血浆的输注是否会传播HCV感染。
Background: It is important to characterize viral dynamics in early hepatitis C virus (HCV) infection to further our understanding of viral pathogenesis and the potential for secondary transmission in acute infection through blood transfusion or other routes.Study Design and Methods: Serial units given by 77 source plasma donors who had evolved from HCV RNA-negative to HCV RNA-positive by nucleic acid amplification technology (NAT) screening with 512-unit pool-NAT or were followed from RNA detection to antibody conversion were tested by individual NAT and quantitative RNA assays.Results: During the ramp-up phase when exponential growth occurs, HCV viral load doubled every 10.8 hours (95% confidence interval [CI], 9.9-12.0). Intermittent viremia was observed before the ramp-up phase in 37 of 50 panels with the earliest detectable viremic bleed occurring 63 days before the estimated onset of ramp-up. The plateau phase or high-titer viremic period that occurs between ramp-up and seroconversion was estimated to last 56.3 days (95% CI, 44.8-67.8).Conclusions: Intermittent low-level HCV viremia can occur as much as 2 months before the periods of exponential increase in viral load and the high-titer plateau-phase viremia that usually precede seroconversion. Animal inoculation studies are in progress to evaluate if transfusion of low-level viremic plasma can transmit HCV infection.