Influence of compartmentalisation in blood upon oral carriage of HCV in Brazilian patients from the city of Recife - Brazil.
Doctoral thesis, UCL (University College London).
Hepatitis C virus (HCV) is an increasingly common cause of liver disease worldwide. HCV may be present in saliva suggesting possible transmission via oral fluids. However the precise influence of peripheral blood carriage of HCV upon the frequency and load of HCV in oral fluids remains unknown. The objectives of the study were to determine the frequency of oral carriage of HCV and determine the influence of plasma and peripheral blood mononuclear cells (PBMCs) HCV levels upon HCV levels in oral fluids. The study group comprised 85 patients with treated (18) or untreated (67) HCV infection resident in northern Brazil. HCV 5’-NCR and NS5b regions were detected by quantitative Real Time PCR and nested block based PCR respectively in whole saliva, plasma, CD2+, CD14+, CD19+, and CD45+ PBMCs for both methods. Approximately 32% of the total group had detectable HCV RNA in whole saliva. In contrast HCV was present in 82.5% of plasma and up to 82.1% of PBMC. There was no significant difference in the genotypes between oral and blood compartments and no evidence of genetic diversity within the oral compartment. There was no correlation between the salivary prevalence of HCV with load of plasma. HCV RNA viral load in saliva was almost always below the level of quantification. Given the low viral load presented in patient with a high plasma titration in the 30% saliva positive patients, HCV transmission via the saliva is highly unlikely, but cannot be discarded. There is no evidence for HCV compartmentalization as sequences from different compartments were closely related, although mutations were identified more frequently within genotype 1b in all compartments. This finding suggest a new trend towards hepatitis C evolution, as genotypes 1a and 1b do not usually differentiate in terms of treatment outcome, being both traditionally related to poor antiviral response.
|Title:||Influence of compartmentalisation in blood upon oral carriage of HCV in Brazilian patients from the city of Recife - Brazil|
|Open access status:||An open access version is available from UCL Discovery|
|UCL classification:||UCL > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute|
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