Hepatitis C virus transmission and its risk factors within families of patients infected with hepatitis C virus in southern Iran:Khuzestan

AIM: To determine whether hepatitis C virus (HCV) infection of index cases increases intrafamilial transmission (sexual and nonsexual contacts) of HCV. METHODS: In a case-control descriptive study we enrolled 300-household contacts of 60 index cases (40 males and 20 females) of HCV infection and 360 pair- matched controls in Ahwaz JundiShapour University Hospitals from August 1, 1998 to September 1, 2003. The control group consisted of first time blood donors referred to the Regional Blood Transfusion Organization. Serum samples and demographic data and a medical history including the existence of risk factors for HCV (after a questionnaire on the risk factors for parenteral exposure) were obtained from each subject. Antibodies to HCV were detected employing a commercially available second-generation enzyme immunoassay (EIA, Abbott Ⅱ). Positive serum specimens were retested using a second-generation recombinant immunoblot assay (RIBA-2) and a polymerase chain reaction for HCV RNA. Data analysis was carried out for intra-household clustering. RESULTS: Only 4 of 300 (1.33%) cases of household contacts without percutaneous risk factors were positive for HCV Ab while the remaining 296 family contacts were negative for anti-HCV. The mean age of the index cases was 28.4 (Std 15.22) years. The anti-HCV prevalences in parents, spouses, children of the index cases were 0.87% (1/115), 3.39% (2/59)) and 0.79% (1/126), respectively. Among couple partners negative for anti-HCV antibodies, the mean duration of the sexual relationship was 6 years.The two-couple partners positive for anti-HCV antibodies married the index cases for longer than 15 years. The prevalence of positive HCV Ab among household contacts (1.33%) was not significantly higher than that in the controls (1%) (P > 0.06). CONCLUSION: Intrafamilial transmission of HCV is not the significant transmission route and sexual transmission does not seem to play a role in the intrafamilial spread of HCV infection. Intrafamilial transmission of HCV is possible but occurs at a low rate.

Comparison of the impact of endoscopic retrograde cholangiopancreatography between pre-COVID-19 and current COVID-19 outbreaks in South Korea:Retrospective survey

BACKGROUND The coronavirus disease 2019(COVID-19)outbreak has markedly influenced the endoscopic patterns.Endoscopic retrograde cholangiopancreatography(ERCP)is an essential technique for pancreatobiliary disease but increases the risk of exposure to the virus-containing body fluid;however,the impact of COVID-19 on ERCP is unknown.AIM To compare the number of endoscopic activities and to analyze the clinical outcomes of ERCPs before and during the COVID-19 outbreak in Daegu,South Kore.METHODS This retrospective cohort study included patients aged≥18 years who underwent ERCP between February 18 and March 28,2020,at a tertiary hospital.ERCP indications and endoscopic details were compared with those from the same period in 2018 and 2019 as control groups.RESULTS Of the 269 ERCP procedures,113(42.0%)cases were performed as emergency procedures.The number of ERCP procedures in 2018 and 2019 decreased by 20.2%and 56.6%,respectively,compared with that in 2020(P<0.01);among the 113 emergency ERCPs,the observed numbers in 2018(n=42)and 2019(n=55)dramatically dropped by 61.9%and 70.9%,respectively,compared with that in 2020(n=16).Of the 16 cases in 2020,stone removal was performed in five,biliary stenting in five,sphincterotomy in five,and nasobiliary drainage in one.No case of ERCP-related infection in medical workers or other patients has been reported.CONCLUSION The COVID-19 outbreak significantly reduced the number of ERCPs;however,there is no difference in the indications and endoscopic interventions before and during the COVID-19 outbreak.