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Title: The molecular diversity of the hepatitis C virus in patients with haemophilia
Author: Devereux, Helen Louise
Awarding Body: University of London
Current Institution: University College London (University of London)
Date of Award: 1996
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The hepatitis C virus (HCV) was first identified in 1989 and shown to be a major cause of non-A, non-B hepatitis. Haemophilic patients have particularly high rates of seroprevalence of HCV, and it is probable that all haemophilic patients treated with unsterilised multi-donor pooled clotting factor concentrates have been exposed to HCV. Infection with HCV is associated with a high rate of chronic liver disease, and a possible progression to cirrhosis and liver failure. The initial study assessed the patterns of HCV RNA in our patients. A minority treated with unsterilised concentrates were found to be persistently HCV RNA negative; these patients may not have been infected or may have cleared the virus. The second study assessed the HCV genotypes pre-and post-treatment with interferon, and found that interferon influenced the dominant, detectable genotypes. The third study assessed five patients from the interferon study in greater detail. The patients' samples were analysed by the four currently available methods for genotyping, and the HCV RNA was quantitated. This study showed no ideal method for genotyping patients with mixed-type infections, but restriction fragment length polymorphism analysis appeared to be the most useful. The final study assessed the evolution of two regions of the HCV genome (the highly conserved 5' untranslated region and an epitope in non-structural region 4) in two patients (one HIV positive and the other HIV negative) over 15 years. Comprehensive clinical information, and the infecting concentrate for the HIV positive patient, was available for both patients, and their clinical condition was compared to the molecular biology of their viruses, including sequence data, quantitation and genotype.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available