BACKGROUND: It is important to characterize viral dynamics in early hepatitis C virus (HCV) infection to further our understanding of viral pathogenesis and the potential for secondary transmission in acute infection through blood transfusion or other routes. STUDY DESIGN AND METHODS: Serial units given by 77 source plasma donors who had evolved from HCV RNA-negative to HCV RNA-positive by nucleic acid amplification technology (NAT) screening with 512-unit pool-NAT or were followed from RNA detection to antibody conversion were tested by individual NAT and quantitative RNA assays. RESULTS: During the ramp-up phase when exponential growth occurs, HCV viral load doubled every 10.8 hours (95% confidence interval [CI], 9.9-12.0). Intermittent viremia was observed before the ramp-up phase in 37 of 50 panels with the earliest detectable viremic bleed occurring 63 days before the estimated onset of ramp-up. The plateau phase or high-titer viremic period that occurs between ramp-up and seroconversion was estimated to last 56.3 days (95% CI, 44.8-67.8). CONCLUSIONS: Intermittent low-level HCV viremia can occur as much as 2 months before the periods of exponential increase in viral load and the high-titer plateau-phase viremia that usually precede seroconversion. Animal inoculation studies are in progress to evaluate if transfusion of low-level viremic plasma can transmit HCV infection.
BACKGROUND: It is important to characterize viral dynamics in early hepatitis C virus (HCV) infection to further our understanding of viral pathogenesis and the potential for secondary transmission in acute infection through blood transfusion or other routes. STUDY DESIGN AND METHODS: Serial units given by 77 source plasma donors who had evolved from HCV RNA-negative to HCV RNA-positive by nucleic acid amplification technology (NAT) screening with 512-unit pool-NAT or were followed from RNA detection to antibody conversion were tested by individual NAT and quantitative RNA assays. RESULTS: During the ramp-up phase when exponential growth occurs, HCV viral load doubled every 10.8 hours (95% confidence interval [CI], 9.9-12.0). Intermittent viremia was observed before the ramp-up phase in 37 of 50 panels with the earliest detectable viremic bleed occurring 63 days before the estimated onset of ramp-up. The plateau phase or high-titer viremic period that occurs between ramp-up and seroconversion was estimated to last 56.3 days (95% CI, 44.8-67.8). CONCLUSIONS: Intermittent low-level HCV viremia can occur as much as 2 months before the periods of exponential increase in viral load and the high-titer plateau-phase viremia that usually precede seroconversion. Animal inoculation studies are in progress to evaluate if transfusion of low-level viremic plasma can transmit HCV infection.
Authors: Gayle Shimokura; Feng Chai; David J Weber; Gregory P Samsa; Guo-Liang Xia; Omana V Nainan; Leslie H Tobler; Michael P Busch; Miriam J Alter Journal: Infect Control Hosp Epidemiol Date: 2011-05 Impact factor: 3.254
Authors: Edward L Murphy; Junyong Fang; Yongling Tu; Ritchard Cable; Christopher D Hillyer; Ronald Sacher; Darrell Triulzi; Jerome L Gottschall; Michael P Busch Journal: J Infect Dis Date: 2010-08-15 Impact factor: 5.226
Authors: Leslie H Tobler; Shrein H Bahrami; Zhanna Kaidarova; Lubov Pitina; Valarie K Winkelman; Sandra K Vanderpool; Anne M Guiltinan; Stewart Cooper; Michael P Busch; Edward L Murphy Journal: Transfusion Date: 2010-03-25 Impact factor: 3.157
Authors: Judith A Hahn; Dennis Wylie; Jesse Dill; Maria S Sanchez; James O Lloyd-Smith; Kimberly Page-Shafer; Wayne M Getz Journal: Epidemics Date: 2009-03 Impact factor: 4.396