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Title: Systematic Review Of Role Of Polymerase Chain Reaction In
Defining Infectiousness Among People Infected With Hepatitis C
Objective: To assess the role of polymerase chain reaction in
defining infectiousness among people infected with hepatitis C
Design: Published studies of hepatitis C transmission were
examined. Twenty nine studies with identified sources of hepatitis
C infection who were tested for presence of hepatitis C RNA by
polymerase chain reaction were reviewed, including studies of
vertical transmission (n = 21), transmission after transplantation
(n = 3), transfusion of blood components (n = 3), and needlestick
exposure (n = 2).
Subjects: All patients identified in studies.
Results: A total of 2022 people who had been exposed to sources
positive for antibody to hepatitis C were identified. Among 1148
people exposed to sources positive by polymerase chain reaction 148
cases of transmission occurred compared with no definite case among
874 people exposed to negative sources. Rates of transmission from
positive sources were 6.2% for perinatal exposure, 6.1% after
needlestick exposure, 78% after solid organ or bone marrow
transplantation, and 83% after transfusion of blood components.
Other factors influencing risk of vertical transmission were
coinfection with HIV and level of hepatitis C viraemia.
Conclusions: Negative results by polymerase chain reaction indicate
an extremely low probability of transmission of hepatitis C from a
person with antibody to hepatitis C.
Author: DORE GJ, UNIV NEW S WALES, NATL CTR HIV EPIDEMIOL and
CLIN RES, DARLINGHURST, NSW 2010
Source: BRITISH MEDICAL JOURNAL 1997 AUG9;315(7104):333-337
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