Identification of acute Hepatitis C Virus infection in Rio de Janerio

可以解释HCV感染结果的机制最可能发生在早期， 感染阶段，但很少有研究能够评估大量患者， 由于大多数患者在此期间没有症状这一限制性事实。的 位于巴西里约热内卢Fiocruz的巴西国家病毒性肝炎参考实验室 在1999年之前确定了至少46例急性HCV感染病例，并在2001年启动了一项 一项试点研究在四年内记录了34起案件。提供临床、实验室和 病毒学数据沿着标本用于HCV感染的免疫应答研究， 规模，我们建议建立一个大型队列的个人有症状和无症状的急性HCV感染。家庭和性传播在急性HCV感染中的作用以及可能影响疾病结局的可能协变量因素将被进一步研究。拟议的研究将侧重于确定两组不同的急性HCV感染者，有症状和无症状，均在巴西里约热内卢肝炎诊所/Fiocruz诊断。有症状受试者将在诊所按照加速筛选算法招募，无症状受试者主要通过 专为针刺伤的卫生专业人员设计的监测计划。 将在特定时间点进行连续采血，以获得PBMC和血浆 补充研究，将前瞻性地分析解决感染所需的各种免疫反应和进展为慢性感染的受试者中的病毒进化。将设计一份详细的流行病学调查问卷，并向研究受试者和受感染的伴侣或家庭成员（他们将捐献血液样本）进行管理，以评估受感染的HCV毒株之间的系统发育相似性。

The mechanisms that could explain the outcome of HCV infection most likely occur in the early phase of infection but few studies have been able to assess large number of patients especially due to the limiting fact that most patients are absent of symptoms during this period. The Brazilian National Reference Laboratory for Viral Hepatitis, Fiocruz, Rio de Janeiro, Brazil has identified at least 46 cases of acute HCV infection before 1999 and in the year 2001 initiated a pilot study that documented 34 cases in a four-year period. To provide clinical, laboratory and virological data along with specimens for immune response studies on HCV infection on a larger scale we propose to establish a large cohort of individuals with symptomatic and non-symptomatic acute HCV infection. The role of household and sexual transmission in acute HCV infection and possible covariate factors that may influence outcome of disease will be additionally investigated. The proposed study will focus on identifying two different groups of individuals with acute HCV infection, symptomatic and non-symptomatic, both diagnosed at the Hepatitis Clinic/Fiocruz, Rio de Janeiro, Brazil. Symptomatic subjects will be recruited following an accelerated screening algorithm at the clinic and the non-symptomatic mainly through a surveillance program specially designed for health professionals with needle stick injuries. Sequential blood draws will be implemented at specific time points to obtain PBMC and plasma for complementary studies that will analyze prospectively a variety of immune responses required to resolve infection and the viral evolution in subjects that progress to chronic infection. A detailed epidemiological questionnaire will be designed and administered to study subjects and to infected partners or household members who will donate blood samples to assess phylogenetic similarity between the infected HCV strains.