Prospective study in 142 cases of hepatitis C virus infection

AIM: There is limited information on the natural history ofHCV infection in China. We investigated the outcome ofHCV infection after nine-year follow-up and the risk factorsin blood donors in China in order to provide the foundationfor prevention and therapy.METHODS: A total of 172 cases of HCV infection with anti-HCV positive and ALT abnormality were enrolled in thearchives when was screened blood in Hebei Province in1993. In them 142 blood donors were followed up till July2002. No antiviral treatment was applied to them duringthe period of infection. In the present study, anti-HCV, HCV-RNA and aminotransferase were detected and genotypingwas conducted by the method of restriction fragment lengthpolymorphism(RFLP). B-type ultrasound detection wasperformed in all the patients. Age, sex, alcohol consumptionand clinical symptoms were questioned.RESULTS: After nine years' follow-up, 10.56% (15/142)of the cases were negative for anti-HCV and 16.42% (12/134)of them were negative for HCV-RNA. The genotypes lb,2a and lb/2a were 91.07%, 6.25% and 2.68% respectively.Twelve cases (8.45%) were negative for both HCV RNAand anti-HCV. The rate of chronicity in this group was83.58% (112/134), and the rate of viral spontaneousresolution was 16.42% (22/134). The mean level of ALT,AST, y-GT in HCV RNA positive cases was significantlyhigher than that in HCV RNA negative cases (P<0.001).The abnormal rate of ALT and/or AST in male donors wassignificantly higher than that in female donors (P = 0.005).The rate of progression to liver cirrhosis from chronic hepatitisC was significantly higher in the cases of super-infectionwith HBV than that in the cases of single HCV infection.Overdose alcohol consumption promoted the progressionto chronicity.CONCLUSION: This area (Hebei Province) has a higherrate of chronicity in HCV infection, and measures shouldbe taken to prevent its progression to serious liver diseases,especially for patients super-infected with HCV and HBV.

Clinical features of probable severe acute respiratory syndrome in Beijing

AIM: To summarize clinical features of probable severe acute respiratory syndrome (SARS) in Beijing.METHODS: Retrospective cases involving 801 patients admitted to hospitals in Beijing between March and June 2003, with a diagnosis of probable SARS, moderate type.The series of clinical manifestation, laboratory and radiograph data obtained from 801 cases were analyzed. RESULTS: One to three days after the onset of SARS, the major clinical symptoms were fever (in 88.14% of patients), fatigue, headache, myalgia, arthralgia (25-36%), etc. The counts of WBC (in 22.56% of patients) lymphocyte (70.25%)and CD3, CD4, CD8 positive T cells (70%) decreased. From 4-7 d, the unspecific symptoms became weak; however, the rates of low respiratory tract symptoms, such as cough (24.18%), sputum production (14.26%), chest distress (21.04%) and shortness of breath (9.23%) increased, so did the abnormal rates on chest radiograph or CT. The low counts of WBC, lymphocyte and CD3, CD4, CD8 positiveT cells touched bottom. From 8 to 16 d, the patients presented progressive cough (29.96%), sputum production (13.09%), chest distress (29.96%) and shortness of breath (35.34%). All patients had infiltrates on chest radiograph or CT, some even with multi-infiltrates. Two weeks later, patients' respiratory symptoms started to alleviate, the infiltrates on the lung began to absorb gradually, the counts of WBC, lymphocyte and CD3, CD4, CD8 positive T cells were restored to normality.CONCLUSION: The data reported here provide evidence that the course of SARS could be divided into four stages, namely the initial stage, progressive stage, fastigium and convalescent stage.