Objectives: The present study aimed to evaluate the prevalence of hepatitis C virus (HCV) infection in nasal lavage (NL) fluid of patients had no history of previous HCV infection.
Patients & Methods: The study was designed as a 2-arm screening study: Group N included 200 randomly chosen patients and started by testing NL fluid for presence of anti-HCV antibodies (anti-HCV Ab) and those with positive result underwent determination of sero-positivity. The other arm consisted of another patients group (Group S; n=200) underwent determination of sero-positivity, and those proved positive underwent determination of positivity of their NL fluid for anti-HCV Ab. PCR identification of HCV RNA was conducted for all positive sera and NL fluid.
Results: Anti-HCV Ab were detected in NL fluid of 7 patients with detection rate of 3.8% and in serum samples of 10 patients with a detection rate of 5% and an overall detection rate of patients with anti-HCV positive of 4.4%. The 7 patients with anti-HCV Ab positive NL fluid were sero-positive; while only 6 of the 10 sero-positive patients had anti-HCV Ab positive NL fluid, thus, determination of anti-HCV Ab in NL fluid could detect sero-positive patients with sensitivity rate of 76.4%. Qualitative PCR detection of HCV-RNA identified viral RNA in 14 serum samples; 13 samples were sero-positive and NL fluid positive and one was sero-positive but NL fluid negative, while the other 3 sero-positive samples were free of viral RNA. Thus, NL fluid anti-HCV Ab positivity could identify patients with viremia with sensitivity and accuracy rates of 92.8% and 94.1%, respectively and could exclude the presence of viremia with a negative predictive value of 75%. Using ROC curve analysis, defined determination of positivity of NL fluid as specific predictor for the presence of viremia with AUC=0.673, while sero-positivity showed AUC=0.500. To evaluate the infectivity of NL fluid, PCR identification of HCV viral RNA in NL fluid was conducted for all NL fluid samples proved positive for antibodies and could detect HCV-RNA in 3 samples with infectivity rate of 17.6%.
Conclusion: It could be concluded that positivity for anti-HCV Ab was detected in 4.4% of the studied population supposed to be free of HCV infection and anti-HCV Ab determination in NL fluid could predict viremia with accuracy rate of 94.1% and could be considered as specific predictor with AUC=0.673 with an infectivity rate of NL fluid was 17.6%. benha Medical Journal 2008