Identification of acute Hepatitis C Virus infection in Rio de Janerio

可以解释丙型肝炎病毒感染结局的机制很可能发生在早期 感染阶段，但很少有研究能够特别评估大量患者 由于有限的事实，大多数患者在这段时间内没有症状。这个 巴西病毒性肝炎国家参考实验室，巴西里约热内卢菲奥克鲁斯 在1999年前发现至少46例急性丙型肝炎感染病例，并在2001年启动了 一项试点研究，在四年内记录了34例病例。提供临床、实验室和 病毒学数据与标本一起用于研究丙型肝炎病毒感染的免疫反应 规模，我们建议建立一个有症状和无症状的急性丙型肝炎病毒感染的大量个体队列。此外，还将调查家庭和性传播在急性丙型肝炎感染中的作用，以及可能影响疾病结局的可能的协变量因素。拟议的研究将侧重于确定两组不同的急性丙型肝炎病毒感染患者，有症状的和无症状的，都是在巴西里约热内卢的肝炎诊所/菲奥克鲁斯确诊的。有症状的受试者将在诊所通过加速筛查算法招募，而无症状的受试者主要通过 专门为有针头刺伤的健康专业人员设计的监测计划。 在特定的时间点进行顺序采血，以获得PBMC和血浆 用于补充研究，这些研究将前瞻性地分析解决感染所需的各种免疫反应，以及进展为慢性感染的受试者的病毒进化。将设计一份详细的流行病学问卷，并向研究对象和将捐献血液样本的受感染伴侣或家庭成员进行管理，以评估受感染的丙型肝炎病毒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.