Hepatitis: Bacq Y

Ossendza RA, Bréchot JF, Fimbel B, Bacq Y. · Hepatogastroenterology department, Trousseau hospital, CHRU de Tours, F-37044 Tours Cedex, France. · Presse Med. · Pubmed #19286345 links to  free full text

This publication has no abstract.

Bacq Y. · Service d'Hépatogastroenterologie, Hôpital Trousseau, CHRU de Tours, 37044 Tours cedex, France. · Gastroenterol Clin Biol. · Pubmed #18662605 No free full text.

Abstract: In pregnant women, hepatitis B virus (HBV) infection presents the risk of mother-to-child (vertical) transmission. The contaminated newborn most often remains a chronic carrier. Mother-to-child transmission can be avoided by serovaccination of the newborn. Screening for HBs antigen is essential in all pregnant women; in France, it is mandatory at the 6-month prenatal examination. All infants born to mothers who are carriers of HBs antigen must receive a serovaccination against this virus, by intramuscular injection of vaccine and of hepatitis B immune globulin (H-BIG, 100 or 200 IU), in two different sites, in the first hours after birth. Vaccination then continues, according to the recommended protocol. Although the combination of vaccination and H-BIG is very effective in preventing chronic carriage in children (efficacy >90 %), some children may nonetheless be contaminated, especially when the viral load is very high during pregnancy. These women with very high viral loads may receive lamivudine treatment at the end of pregnancy to diminish viral load and thus the risk of chronic carriage in the child; however the role of this drug in this situation is not yet clearly defined. The efficacy of the serovaccination must be confirmed in all children by a serologic examination (HBs antigen and anti-HBs antibodies) at some time after the last vaccination. Children carrying the HBs antigen must be seen by a pediatrician who has experience with viral hepatitis. When HBs antigen is found in a woman during pregnancy, a specialist should be consulted and the family should undergo complete serologic testing (HBs antigen, anti-HBc and anti-HBs antibodies).

Bacq Y. · Service d'Hépatogastroentérologie, Hôpital Trousseau, Tours, France. · Pathol Biol (Paris). · Pubmed #10609276 No free full text.

Abstract: Transaminase level elevation during pregnancy should be viewed as abnormal and evaluated. A high index of suspicion for acute fatty liver of pregnancy should be maintained during the third trimester, since early delivery has radically transformed the maternal and fetal prognosis of this condition. Pruritus is the main symptom of intrahepatic cholestasis, which carries a risk for the fetus. Urinary tract infection can cause cholestasis or worsen intrahepatic cholestasis of pregnancy. In patients with preeclampsia, rapid delivery should be considered if there is evidence of HELLP syndrome. Patients with mild chronic viral hepatitis can usually carry a pregnancy to term without undue difficulty. Neonates born to HBsAg-positive mothers should receive HBV-Ig and vaccine at birth to prevent perinatal transmission of the HBV. In patients with chronic hepatitis C, serum transaminase levels often return to normal during pregnancy, although the virus remains detectable in the blood. Mother-to-infant transmission of the HCV is possible but fairly uncommon if the mother is HIV-negative.

Causse X, Si Ahmed SN, Gros J, Loustaud-Ratti V, Bacq Y, Abergel A, Silvain C, Veillon P, Labarriere D, Giraudeau B, Anonymous00408. · Service d'Hépato-Gastroentérologie, CHR La Source, BP 6709, 45067 Orléans Cedex 2. · Gastroenterol Clin Biol. · Pubmed #15795657 links to  free full text

Abstract: AIM: About 45% of patients with chronic hepatitis C are unresponsive to the present reference treatment combining pegelated interferon plus ribavirin; before pegylated interferon was available the non-response rate was around 60%. This open multicenter pilot study, initiated before pegylated interferon became available, was designed to evaluate, in patients unresponsive to interferon monotherapy, the rate of biological and virological response and side-effects of the ribivirin-alpha 2b interferon combination. METHODS: The combination protocol was ribavirin (1 to 1.2 g/d) plus alpha 2b interferon at induction doses (9 MU/d the first week; 4.5 MU/d the eleven following weeks; 3 MU/2 days the 36 following weeks). RESULTS: Among the 27 included patients, 17 (63%) were viremia-negative (PCR) after 12 weeks of treatment, 9 (33%) were complete responders (undetectable viremia and normal transaminases) at the end of treatment (48 weeks) and of follow-up (72 weeks). Patients with non-1, non-4 genotypes who derived full benefit from this therapeutic strategy (6/7 (86%) were complete responders: 4/5 with genotype 3 and 2/2 with genotype 5). Quality-of-life was impaired during treatment, especially during the first 12 weeks of high-dose interferon therapy. CONCLUSION: While waiting for new therapeutic possibilities, these good results suggest interferon induction at the beginning of treatment remains a valid option.

Lunel F, Veillon P, Fouchard-Hubert I, Loustaud-Ratti V, Abergel A, Silvain C, Rifflet H, Blanchi A, Causse X, Bacq Y, Payan C, Anonymous00122. · Laboratoire de Bactériologie-Virologie, CHU Angers, Angers Cedex, France. · J Hepatol. · Pubmed #14568267 No free full text.

Abstract: BACKGROUND/AIMS: To evaluate the efficacy of ribavirin, given in second intention in non-responders to interferon alone, by studying viral kinetics. METHODS: We conducted a trial including 203 patients with chronic hepatitis C, naïve of treatment. Patients were treated with interferon three times a week with or without ribavirin and amantadine according to response. Viral kinetics were assessed by serial measurements of HCV RNA (bDNA 3.0 and Monitor 2.0) and a new assay, trak-C, able to quantify total Hepatitis C virus (HCV) core antigen. RESULTS: A significant initial drop in HCV RNA or HCV core antigen, under interferon alone, was associated with response to therapy, -4.85+/-1.33 log for HCV RNA in sustained responders versus -1.86+/-1.53 log for others groups, P<0.001. In patients receiving ribavirin in second intention, we also observed a similar drop in HCV RNA and HCV core antigen, predictive of sustained response, -2.67+/-1.26 log for HCV RNA in sustained responders versus -0.44+/-0.49 log in non-responders, P<0.001. CONCLUSIONS: Ribavirin has probably an additional antiviral effect in interferon treated patients. Kinetics of HCV RNA and HCV core antigen under treatment are highly predictive of a sustained virological response.

Boursier J, Bacq Y, Halfon P, Leroy V, de Ledinghen V, de Muret A, Bourlière M, Sturm N, Foucher J, Oberti F, Rousselet MC, Calès P. · Hepatogastroenterology Department, CHU, Angers, France. · Eur J Gastroenterol Hepatol. · Pubmed #19060630 No free full text.

Abstract: OBJECTIVE: Blood tests are usually designed to identify significant fibrosis. We evaluated their diagnostic accuracy, and how to increase it, for the clinically important targets of severe fibrosis and cirrhosis. METHODS: The accuracy for severe fibrosis or cirrhosis of four blood tests was evaluated based on Metavir staging in 1056 patients with chronic hepatitis C recruited in five independent hospitals. RESULTS: Using original scores, an original diagnostic target (significant fibrosis) and best diagnostic cutoff, the correct classification rates in severe fibrosis and cirrhosis stages were, respectively: FibroMeter: 90.1, 100%, Fibrotest: 78.2, 95.1%, Hepascore: 73.8, 94.9%, aspartate aminotransferase to platelet ratio index (APRI): 71.4, 88.0% (P<0.003, P=0.004, respectively, between tests). The corresponding area under the receiver operating characteristics were FibroMeter: 0.885, 0.907, Fibrotest: 0.837, 0.882, Hepascore: 0.834, 0.896, APRI: 0.822, 0.841 (P<0.003, respectively). Observed 100% negative predictive values for severe fibrosis and cirrhosis were, respectively, FibroMeter: 15.4, 47.5%, Fibrotest: 3.6, 31.9%, Hepascore: 0.3, 24.6%, APRI: 1.4, 5.3% of patients (P<0.003, respectively, between tests). By calculating a specific test for cirrhosis, including the FibroMeter markers, the correct classification (93.0%) was significantly higher for the cirrhosis diagnosis compared with the original FibroMeter (90.9%, P=0.005). This specific test provided a 100% positive predictive value for cirrhosis diagnosis versus 88% for original FibroMeter. CONCLUSION: Using the most accurate original test, cirrhosis can be excluded in 47.5% of patients and is correctly diagnosed, as significant fibrosis, in 100% of patients. A specific test for cirrhosis provides a significant gain in diagnostic accuracy to 93% and in positive predictive value to 100% compared with the original test.

Calès P, Boursier J, de Lédinghen V, Halfon P, Bacq Y, Leroy V, Dib N, Oberti F, Sawadogo A, Rousselet MC, Lunel F. · Service d'hépatogastroentérologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 09, France. · Gastroenterol Clin Biol. · Pubmed #19019606 links to  free full text

Abstract: OBJECTIVE: To evaluate the rates of reliable diagnosis of cirrhosis by two usual blood tests. METHODS: Reliable diagnosis was mainly evaluated by comparing rates of positive (PPV) and negative (NPV) predictive values with FibroTest and FibroMeters, as either standard test or specifically designed for cirrhosis, in 1056 patients with chronic hepatitis C. RESULTS: Using the diagnostic limits provided by fibrosis stage scales, the PPV for cirrhosis was: standard FibroMeters: 68.5% versus FibroTest: 37.1%. Using 95% PPV, the cirrhosis detection rate was: specific FibroMeter: 26.1% versus FibroTest: 2.0% (P<10(-3)). The cirrhosis detection rate increased from 26 to 65% by performing liver biopsy in 8% of patients with indeterminate results on specific FibroMeter between 95% NPV and PPV. On the other hand, specific FibroMeter provided three intervals of 95% reliable diagnosis with no biopsy: less than or equal to 95% NPV: no cirrhosis (threshold: diagnosis); significant fibrosis; and greater than or equal to 95% PPV: cirrhosis. CONCLUSION: The detection rate and PPV for cirrhosis using fibrosis scales were fair for standard FibroMeter and poor for FibroTest. Around one-fourth of cases of cirrhosis are detected by the 95% PPV of specific FibroMeter, and around two-thirds by performing an additional liver biopsy in only 8% of patients. Finally, specific FibroMeter can avoid liver biopsy by classifying patients into three categories: no cirrhosis; significant fibrosis; and cirrhosis.

Negreanu L, Baty G, Dubois F, de Muret A, Bacq Y. · Department of Hepato-gastro-enterology, Trousseau Hospital, Tours Regional University Hospital, Tours, France. · Dig Liver Dis. · Pubmed #18819852 No free full text.

Abstract: A case of hepatitis B virus reactivation leading to the diagnosis of a T cell lymphoma is reported. A 66-year-old woman with a past history (10 years before) of spontaneously recovered acute hepatitis B (with disappearance of serum hepatitis B surface antigen and appearance of anti-HBs), has been referred for hepatologic consultation for acute hepatitis. The patient was found positive again for hepatitis B surface antigen as well HBeAg and hepatitis B virus DNA. No other cause of liver disease was identified and a diagnosis of spontaneous hepatitis B virus reactivation was made. Five months later a peripheral T cell lymphoma was diagnosed. This unusual case confirms that natural immunity is not protective against hepatitis B virus reactivation and shows that such hepatitis B virus reactivation may precede the usual clinical manifestations of a peripheral T cell lymphoma.

Leroy V, Halfon P, Bacq Y, Boursier J, Rousselet MC, Bourlière M, de Muret A, Sturm N, Hunault G, Penaranda G, Bréchot MC, Trocme C, Calès P. · Clinique d'Hépato-Gastroentérologie, Pôle Digestif-DUNE, CHU, Grenoble, France. · Clin Biochem. · Pubmed #18655779 No free full text.

Abstract: OBJECTIVES: To evaluate the diagnostic accuracy of liver fibrosis tests and its influencing factors in a meta-analysis with individual data. DESIGN AND METHODS: Four independent centers provided four blood tests and Metavir staging from 825 patients with chronic hepatitis C. RESULTS: FibroMeter AUROC (0.840) for significant fibrosis was superior to those of Fibrotest (0.803, p=0.049), APRI (0.789, p=0.001) and Hepascore (0.781, p<0.001). The misclassification rate was lower for FibroMeter (23%) than for Fibrotest and Hepascore (both 28%, p<0.001). The variation in the diagnostic cut-offs of tests among centers, reflecting the overall reproducibility, was: FibroMeter: 4.2%, APRI: 24.0%, Fibrotest: 24.2%, Hepascore: 35.0%. Accordingly, the proportion of patients diagnosed with significant fibrosis changed: FibroMeter: 0.8%, Hepascore: 2.4% (p=0.02 vs FibroMeter), Fibrotest: 5.8% (p<10(-3)), APRI: 18.2% (p<10(-3)). CONCLUSIONS: This study on clinical applicability shows significant differences in diagnostic accuracy, inter-center reproducibility, and robustness of biomarkers to changes in population characteristics between blood tests.

Calès P, de Ledinghen V, Halfon P, Bacq Y, Leroy V, Boursier J, Foucher J, Bourlière M, de Muret A, Sturm N, Hunault G, Oberti F. · Service d'Hépato-gastroentérologie et laboratoire HIFIH, IFR 132, CHU, Angers, France. · Liver Int. · Pubmed #18492022 links to  free full text

Abstract: BACKGROUND: The reliable diagnosis rate of diagnostic tests is provided by their intervals with acceptable accuracy (e.g. >/=90%) where a liver biopsy can be avoided. AIMS: To evaluate the overall accuracy and improve the reliable diagnosis rates of blood tests for significant liver fibrosis. METHODS: Five blood tests were compared with Metavir fibrosis (F) staging in 1056 patients with chronic hepatitis C. RESULTS: Area under the receiver operating characteristics (F0-1 vs. F2-4) were: FibroMeter: 0.853, Fibrotest: 0.811, Fib-4: 0.799, aspartate aminotransferase to platelet ratio index (APRI): 0.786 and Hepascore: 0.784 (P<10(-3) between tests). The reliable diagnosis rates based on two traditional intervals defined by thresholds >/=90% of negative predictive values (NPV) and positive predictive values (PPV), diagnosing F0/1 and F2/3/4, respectively, were: FibroMeter: 43.5%, APRI: 19.6%, Fibrotest: 17.1%, Hepascore: 3.9%, Fib-4: 1.7% (P<10(-3)). By dividing the indeterminate interval by the diagnostic cut-off, two new intervals could be diagnosed reliably: F1/2 and F1/2/3. Accordingly, the reliable diagnosis rate was increased, e.g. FibroMeter: 75.5% (accuracy: 89.5%) with three intervals (F0/1, F1/2, F2/3/4). It was possible to further increase this rate by using the more exportable 90% sensitivity/specificity thresholds, e.g. FibroMeter: 90.2% (accuracy: 86.4%). By using the four intervals, the reliable diagnosis rate was 100% (accuracy: 89.5% with predictive value (PV) and 87.5% with sensitivity/specificity). CONCLUSION: Reliable diagnosis is a diagnostic index devoted to clinical practice. Its rate can be increased by creating new intervals between diagnostic cut-off and 90% PVs or sensitivity/specificity thresholds. This increased the overall accuracy from 78.1 to 89.5% and reduced the need for a liver biopsy from 56.5 to 0% with the most accurate test.

Deest G, Zehner L, Nicand E, Gaudy-Graffin C, Goudeau A, Bacq Y. · Service d'Hépatogastroentérologie, Hôpital Trousseau, CHRU de Tours. · Gastroenterol Clin Biol. · Pubmed #18176364 No free full text.

Abstract: Viral hepatitis E is an endemic infection in developing countries. Emerging cases of autochthonous hepatitis E have been observed in developed countries, especially in France. Transmission route of those cases remains unknown and contamination may occur from an animal reservoir. We report two new cases of hepatitis E simultaneously diagnosed in a couple after a trip in southern France. Diagnosis was based on detection of anti-HEV IgM and HEV RNA in sera of the two patients. Epidemiologic investigation revealed that the two patients had eaten undercooked pig meat four weeks before the onset of the jaundice. This report suggests that consumption of undercooked pork meat may be responsible for the contamination by hepatitis E virus in France as it was described in Japan.

Aubourg A, d'Alteroche L, Senecal D, Gaudy C, Bacq Y. · Service d'Hépato-Gastroentérologie, Hôpital Trousseau, Tours. · Gastroenterol Clin Biol. · Pubmed #17273140 No free full text.

Abstract: We report a case of autoimmune thrombocytopenia associated with acute reverse seroconversion of hepatitis B in a patient who was initially hepatitis B virus surface antigen negative and hepatitis B virus surface antibody positive. Reactivation occurred 9 months after chemotherapy with anti-CD 20 monoclonal antibodies and autologous hematopoietic stem cell transplantation for lymphoma had been performed. After non specific polyglobulin injections and treatment with adefovir dipivoxil, thrombocytopenia and viral replication were controlled. Seroconversion for both HBe and HBs occurred at 5 months. Adefovir was stopped 4 months later with no relapse during fifteen months of follow-up. This case shows that patients who have had previous contact with hepatitis B virus should be monitored if they become immunosuppressed, even if anti-HBs were initially present.

Halfon P, Bacq Y, De Muret A, Penaranda G, Bourliere M, Ouzan D, Tran A, Botta D, Renou C, Bréchot MC, Degott C, Paradis V. · Laboratoire Alphabio, 23 rue Friedland, 13006 Marseille, France. · J Hepatol. · Pubmed #17156890 No free full text.

Abstract: BACKGROUND/AIMS: We evaluated the test performance profile (TPP) of blood tests of liver fibrosis. METHODS: Three hundred and fifty-six patients with C chronic hepatitis were included in two centers. Metavir staging of liver specimens by two independent pathologists and the following tests were evaluated: Fibrotest (FT), APRI, FibroMeter (FM), and Hepascore (HS). RESULTS: Metavir stages were: F0: 4%, F1: 55%, F2: 26%, F3: 11%, and F4: 4%. The AUROCs were not significantly different, respectively, FT, FM, APRI, HS: >or=F2: 0.79, 0.78, 0.76, >or=0.76; F3: 0.81, 0.85, 0.81, 0.81; and F4: 0.86, 0.94, 0.92, 0.89. The TPP relies on the paired comparison of blood-test misclassification based on liver specimen, e.g. FT vs FM, respectively: F0+1: 18 vs 28% (p=0.0003), >or=F2: 43 vs 31% (p=0.004). There was no center effect. CONCLUSIONS: In those populations, the four blood tests had a similar performance for significant fibrosis (F>or=2), lying in the lower range of published results which is attributable to a low >or=F2 prevalence, and for >or=F3 and F4. However, FM and FT had performance profiles significantly different as a function of fibrosis stages or diagnostic target (fibrosis cut-off). This has to be considered during the interpretation process. Moreover, the performance should be reported with different diagnostic targets.

Naouri M, Bacq Y, Machet MC, Rogez C, Machet L. · Service de Dermatologie, Centre Hospitalier Universitaire, Université François-Rabelais, Tours, France. · Ann Dermatol Venereol. · Pubmed #17053737 No free full text.

Abstract: BACKGROUND: Hepatitis C virus (HCV) frequently causes leucocytoclastic vasculitis as a result of type II or III cryoglobulinemia. HCV-associated vasculitis without cryoglobulinemia is less common. PATIENTS AND METHODS: A 33-year-old woman consulted for infiltrative necrotic purpura of the lower limbs, responsible for leg ulcers measuring less than 1 cm. Histopathological examination revealed vasculitis affecting the hypodermic arterioles and caused by periarteritis nodosa. No extracutaneous involvement was observed. The patient had presented asymptomatic untreated HVC infection (genotype 3) for two years. Antiviral treatment resulted in elimination of the patient's viremia and no relapse of skin lesions was observed two years after the end of treatment. COMMENTS: This patient presented vasculitis due to cutaneous nodular periarteritis associated with HVC without cryoglobulinemia. Hepatic impairment was mild and did not require any antiviral treatment. No further skin involvement was seen after treatment with colchicine and because the patient's viral genotype was favorable, we decided to initiate antiviral therapy. This therapeutic approach should be considered by dermatologists, but it is nevertheless important to assess the risk of interferon-induced aggravation of vasculitis.

Aubourg A, Ayoub J, Bacq Y, Arbeille P. · Service d'Hépato-Gastroentérologie, CHU Trousseau 37044 Tours Cedex. · J Radiol. · Pubmed #16788542 links to  free full text

Abstract: Liver biopsy is an invasive procedure which is widely used for the management of liver diseases. An asymptomatic pneumothorax was detected on sonography prior to biopsy for chronic hepatitis C. The complications from biopsy, potentially severe, are decreased by ultrasound guidance. Currently, ultrasound guidance is recommended at the time of liver biopsy.

d'Alteroche L, Majzoub S, Lecuyer AI, Delplace MP, Bacq Y. · Service d'Hépato-Gastroentérologie, Hôpital Trousseau, 37044 Tours cedex, France. · J Hepatol. · Pubmed #16223542 No free full text.

Abstract: BACKGROUND/AIMS: Ophthalmologic side effects have been reported during interferon therapy, particularly retinal lesions and neurovisual impairment. The aim of this prospective study was to assess the nature and the frequency of such lesions during alpha-interferon therapy for viral hepatitis. METHODS: Between 1995 and 2003, 156 patients treated with standard or pegylated alpha-interferon, with or without ribavirin, had a regular ophthalmologic examination before and during treatment. No patient had signs of retinopathy before treatment. Cotton-wool spots were found in 31 patients and retinal hemorrhage in nine patients during treatment (24% of patients). These lesions remained asymptomatic and disappeared in all patients. A previous history of arterial hypertension (RR 4.60, 95% CI 1.95-10.85), age above 45 years (RR 2.80, 95% CI 1.36-5.85), and use of pegylated alpha-interferon (RR 2.75, 95% CI 1.41-5.38) were significantly associated with retinopathy. Neurovisual impairment was present in 31 patients (20%) before treatment and in 74 patients (47%) during treatment. CONCLUSIONS: In conclusion, this study showed that signs of retinopathy and neurovisual impairment were common in patients receiving alpha-interferon therapy but were rarely symptomatic. It suggests that alpha-interferon may usually be continued in asymptomatic patients as long as there is careful fundoscopic examination.

d'Alteroche L, Assor P, Lefrou L, Senecal D, Gaudy C, Bacq Y. · Service d'Hépato-Gastroentérologie, Hôpital Trousseau. l.d' · Gastroenterol Clin Biol. · Pubmed #15864183 No free full text.

Abstract: We report the case of a 45-year-old man admitted for severe autoimmune thrombopenia and neutropenia associated with chronic viral C hepatitis. After failed, intravenous gammaglobulin and corticosteroid therapy antiviral treatment with interferon and ribavirin was given for one year. Thrombopenia improved progressively during antiviral therapy and worsened after the end of treatment. Neutropenia improved during antiviral therapy. Two years after the end of treatment, serum RNA-HCV was positive, white cell count was normal and platelet count was 77 G/L. In conclusion, these results suggest that antiviral therapy may be useful in patients with auto-immune cytopenia associated with viral hepatitis C infection.

Corcia P, Barbereau D, Guennoc AM, de Toffol B, Bacq Y. · Department of Neurology, CHRU Bretonneau, Tours, France. · Neurology. · Pubmed #15249636 No free full text.

Abstract: A 57-year-old man with chronic inflammatory demyelinating polyneuropathy associated with hepatitis C virus infection was treated successfully with the combination of peginterferon-alpha-2b and ribavirin. Viral eradication was confirmed during the 4th week of treatment and was followed 3 weeks later by neurologic improvement. The patient resumed normal activity 1 year after the therapy was completed.

Tchuenbou J, Bacq Y, Fimbel B, Metman EH. · Service d'Hépato-Gastro-Entérologie, Hôpital Trousseau, CHU Tours, 37044 Tours Cedex. · Gastroenterol Clin Biol. · Pubmed #12910230 No free full text.

Abstract: We report the case of a 18-year-old woman with portal vein thrombosis and chronic hepatitis C virus. Portal vein thrombosis was diagnosed by chance on ultrasound examination during initial hepatitis C virus-positive patient screening. The patient interview revealed a history including exchange transfusion at birth, followed by necrotising ulcerocolitis and septicemia. The investigation of general factors favoring thrombosis showed acquired protein S deficiency and heterozygous factor V Leiden mutation. This case demonstrates the value of systematic investigations for general thrombophilic factors in cases of portal vein thrombosis even when a local cause is found.

Muñoz Sastre MT, Bacq Y, Mullet E, Sorum PC. · Université de Toulouse II, Toulouse, France. · Prev Med. · Pubmed #12052019 No free full text.

Abstract: BACKGROUND: Knowing the facts and displaying the proper attitudes and behaviors are critical in preventing the spread of infectious diseases. Hepatitis C is a common infection, but the public's understanding of it has not been studied. METHODS: A convenience sample of 431 French adults, ages 18 to 81 years, completed a questionnaire designed to assess knowledge of hepatitis C and acquired immune deficiency syndrome. A group of nine medical experts also answered the hepatitis C questions. RESULTS: The lay participants had many uncertainties about hepatitis C, and their beliefs frequently differed from medical understanding about hepatitis C. Their responses were correlated more closely with their own responses to the AIDS questions than with the experts' understanding of hepatitis C. CONCLUSIONS: Information regarding hepatitis C should emphasize the distinctions between hepatitis C and AIDS as well as between hepatitis C and hepatitis B and between seropositivity and infection. People should also be informed that blood donation is safe, that using injected drugs is the main risk factor for hepatitis C, that alcohol aggravates hepatitis C, that hepatitis C can cause cancer, that an effective treatment for hepatitis C exists, and that they are not put at risk by mere causal contact with people ill with hepatitis C.

Bacq Y. · Service d'Hépato-Gastroentérologie, Hôpital Trousseau, 37044 Tours Cedex, France. · Gastroenterol Clin Biol. · Pubmed #11695345 No free full text.

This publication has no abstract.

Proust B, Dubois F, Bacq Y, Le Pogam S, Rogez S, Levillain R, Goudeau A. · Département de Microbiologie Médicale et Moléculaire, Unité de Virologie, Centre Hospitalier Universitaire Bretonneau, Tours, France. · J Clin Microbiol. · Pubmed #10921996 links to  free full text

Abstract: We report the case of an occasional intravenous drug user who developed two successive hepatitis C virus (HCV) infections. The first infection led to seroconversion (anti-HCV antibodies detected) and the detection of HCV RNA in serum. After a spontaneous recovery (normalization of alanine aminotransferase levels and HCV RNA clearance), a second HCV infection was observed, with the recurrence of HCV viremia. Antibody directed against HCV serotype 1 was detected throughout the follow-up monitoring, but two different HCV strains were identified during the two infectious episodes: genotype 1a for the first and genotype 3a for the second. This observation shows that primary HCV infection does not confer protective immunity against subsequent infection with viruses of other genotypes. This may hamper the development of a vaccine. Conflicting results were obtained in genotyping and serotyping assays, suggesting that the serotyping method cannot be used to identify the HCV type in patients, such as intravenous drug users, who are exposed to successive HCV infections.

Gervais A, Bacq Y, Bernuau J, Martinot M, Auperin A, Boyer N, Kilani A, Erlinger S, Valla D, Marcellin P. · Service d'Hépatologie, INSERM U481 and Centre de Recherche Claude Bernard sur les Hépatites Virales, Hôpital Beaujon, Clichy, France. · J Hepatol. · Pubmed #10707870 No free full text.

Abstract: BACKGROUND/AIMS: The natural history of chronic hepatitis C infection during pregnancy has not been clearly established, and thus our aim was to assess serum alanine aminotransferase levels and serum HCV RNA levels during pregnancy. METHODS: Twenty-six pregnant women with chronic hepatitis C were studied. Serum alanine aminotransferase was assessed within the 3 months before, monthly during and within the 3 months after pregnancy. In 12 women, serum HCV RNA levels were quantified by the branched DNA assay. Twenty-six age-matched non-pregnant women with chronic hepatitis C were followed up for 1 year, and used as a comparison group. RESULTS: During pregnancy, serum alanine aminotransferase levels decreased in the second and third trimesters. The third trimester levels were significantly lower than serum alanine aminotransferase levels before pregnancy (p=0.0001). Seventy-seven percent of the pregnant women with increased pre-pregnancy levels had normalization of serum alanine aminotransferase levels. In the second or third trimesters, serum HCV RNA levels increased. The third trimester serum HCV RNA levels were significantly higher than levels before pregnancy (p=0.01). No significant change in serum alanine aminotransferase or HCV RNA levels was observed in the control group. CONCLUSION: In pregnant women with chronic hepatitis C, serum alanine aminotransferase levels decrease, and serum HCV RNA levels increase during the second and third trimesters.

D'alteroche L, Dubois F, Bacq Y. · No affiliation provided · Gastroenterol Clin Biol. · Pubmed #16518294 No free full text.

This publication has no abstract.

Tchuenbou J, de Muret A, Dumont P, Bacq Y. · No affiliation provided · Gastroenterol Clin Biol. · Pubmed #15094689 No free full text.

This publication has no abstract.