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8. Medicina di Laboratorio

Author

Zatti, M, Coglio, A, Grigis, A, Guidi, Giancesare, Santonastaso, Clara, Lippi, Giuseppe, Manzato, F, Marchiaro, G, and Spandrio, L.

Published
2006

9. Occult hepatitis B virus infection in HBsAg negative patients undergoing liver transplantation: clinical significance

Author

Ghisetti, V, Marzano, A, Zamboni, F, Barbui, A, Franchello, A, Gaia, S, Marchiaro, G, Salizzoni, Mauro, and Rizzetto, Mario

Subjects
Adult, Male, Hepatitis B Surface Antigens, Treatment Outcome, Host vs Graft Reaction, Prevalence, Humans, Female, Middle Aged, Hepatitis B, Liver Failure, Aged, Liver Transplantation
Abstract

Occult Hepatitis B virus (o-HBV) infection has been reported in HB surface antigen (HBsAg)-negative liver donors whose risk of transmitting HBV justifies a specific prophylaxis in liver recipients. The clinical significance of o-HBV infection in HBsAg-negative recipients and their need for prophylaxis is unknown. Liver samples collected during surgery from 23 HBsAg-negative patients (9 liver donors and 14 recipients) and 20 HBsAg-positive recipients (controls) were studied by polymerase chain reaction with an independent set of primers mapping the core and surface HBV genes. Intrahepatic HBV DNA was detected as core and surface genes in all the HBsAg-positive recipients, in none of the HBsAg-negative donors and in 9/14 (64%) of the HBsAg-negative recipients (2 HCV negative, 7 HCV positive). The intrahepatic amount of HBV was significantly lower in HBsAg-negative than in HBsAg-positive livers (median values 1.36 Log(10)/microg DNA vs. 3.66 Logs, p0.0001, core gene, and 1.13 vs. 6.21 Logs p0.0001, surface gene). No HBV DNA was detected in plasma from o-HBV recipients; one of them tested positive in lymphocytes. No correlation was found between o-HBV and serologic markers of previous HBV exposure, response to vaccination, acute rejection, hepatitis D and G virus-infections. None of o-HBV carriers experienced a de novo hepatitis B after transplantation (median follow-up: 477 days). Occult HBV is frequent in HBsAg-negative liver recipients. It is not associated with increased episodes of acute rejection, coinfection with hepatotropic viruses, different responses to HBV vaccination, or the development of de-novo hepatitis B. In o-HBV infection a particular virus-host interaction can explain the low intrahepatic HBV content and the lack of extrahepatic HBV replication, thus justifying the low risk of hepatitis B reactivation, in absence of specific prophylaxis, once the recipient liver is removed.

Published
2004

12. Extrahepatic immunological manifestations of hepatitis C virus in dialysis patients

Author

Canavese, C., Hollo, Z., Giovannino Ciccone, Ghisetti, V., Barbui, A., Fop, F., Martina, G., Forgnone, F., Novo, P., Thea, A., Grill, A., and Marchiaro, G.

Subjects
Adult, Aged, 80 and over, Male, Comorbidity, Hepacivirus, Hepatitis C Antibodies, Middle Aged, Hepatitis C, Polymerase Chain Reaction, Cohort Studies, Logistic Models, Immune System Diseases, Peritoneal Dialysis, Continuous Ambulatory, Risk Factors, Confidence Intervals, Odds Ratio, Prevalence, Humans, Kidney Failure, Chronic, Female, Aged
Abstract

Hepatitis C virus (HCV) infection may be associated with various extrahepatic immunological disorders. Uremic patients on chronic regular dialytic treatment (RDT) frequently develop immunological abnormalities. The aim of this study was to evaluate the probability that HCV infection creates an increased risk for extrahepatic immunological abnormalities in chronic RDT patients.In a series of one hundred sixteen chronic RDT patients, HCV status was determined by anti-HCV antibodies, polymerase chain reaction (PCR) RNA and viral genotyping. After excluding four anti-HCV negative/PCRRNA positive patients, a comparison was made between 51 anti-HCV negative/PCR-RNA negative and 61 anti-HCV positive patients, this latter group including seventeen PCR-RNA negative, fifteen genotype 1, thirteen genotype 2, three genotype 3, four genotype 4, four undeterminable genotype and five mixed genotypes. The following investigations were performed: cryoglobulinemia (presence, titer and, when possible, identification), monoclonal gammopathy, antineutrophil cytoplasm antibodies, antidouble stranded DNA antibodies, circulating immunocomplexes and immunoglobulin levels.Cryoglobulinemia was found in 77% of anti-HCV positive versus 29% of anti-HCV negative patients, and cryocrit1% in 50% versus 9.8% respectively, p=0.01. Also cryoglobulin concentration was higher (logarithmic transformation: 4.38 +/- 0.94 vs 3.11 +/- 1.06, p =0.001) in anti-HCV positive versus negative patients. Multivariate logistic regression analysis showed a significantly increased odds ratio (12.0, confidence interval 3.0 to 48.3) for having high levels of cryoglobulins (cryocrit1%) after adjusting for age and dialytic age. The prevalence of this abnormality did not differ significantly among patients infected with different genotypes, but a tendency towards a lower frequency was observed in the anti-HCV positive/PCR negative subgroup. Cryoglobulins were identified as type I (2 anti-HCV positive case), type II (2 anti-HCV positive and 1 anti-HCV negative case) and type 3 (1 anti-HCV negative case). The frequency of monoclonal gammopathy was not significantly different between anti-HCV positive and anti-HCV negative patients (6.5% versus 2%) as well as that of the other parameters evaluated except for IgG concentration which was higher in the anti-HCV positive group (1,685 +/-605 versus 1349 +/- 352 mg/dl, p 0.006). Five events, potentially linked to HCV infection, occurred in our anti-HCV positive patients: 2 cases of porphyria cutanea, 1 case of unexplained peripheral neuropathy, 1 cutaneous leukocytoclastic vasculitis, 1 death for non-Hodgkin's lymphoma. In one anti-HCV positive patient treated with interferon-alpha, the presence of cryoglobulins, monoclonal gammopathy and high IgG levels strictly paralleled that of viremia, disappearing during the recovery phase under treatment and reappearing shortly after stopping treatment.HCV infection provides a significantly increased risk for developing extrahepatic immunological abnormalities also in chronic RDT patients. It is possible that the clinical relevance of this event might be scant because of the low level of these abnormalities, but an awareness of its possibility should to be taken into account.

Published
2000

20. REAL-TIME PCR PER LA RICERCA DI HCV RNA NEL PLASMA.

Author

Cerutti, F., primary, Allice, T., additional, Gabella, S., additional, Pittaluga, F., additional, Varetto, S., additional, Giliberto, G., additional, Martelli, S., additional, Smedile, A., additional, Ghisetti, V., additional, and Marchiaro, G., additional

Published
2006
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43. CagA positive Helicobacter pylori infection is found in 96% of gastric cancer cases in Italian patients

Author

Pugliese, G., primary, Sanseverino, P., additional, De Giuli, M., additional, Margaria, E., additional, Soldati, T., additional, Valente, G., additional, De Marco, L., additional, Perotto, C., additional, Parello, G., additional, Morgando, A., additional, Cassarino, E., additional, Marchiaro, G., additional, Fronda, G.R., additional, Verme, G., additional, and Ponzetto, A., additional

Published
1995
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