However, the incidence and prevalence of IBD has increased rapidly over the last two to four decades. These changes may correlate to the life changes in Asia close to the Western country. We will see the characteristic of our IBD patients from colonoscopy findings. Methods: Descriptive study to describe Inflammatory Bowel Disease (IBD) patients characterized who underwent colonoscopy at Cipto Mangunkusumo

Hospital (RSCM) from 2009 until 2013. We had 2,234 patients who underwent colonoscopy from January 2009 until December 2013. Results: From colonoscopy OSI-906 nmr patients, there were normal colonoscopy 14.2%, hemorrhoid 66.3%, tumor 20.5%, polyp 13.2%, IBD 9.8%, infective colitis 6.2% and ileitis 5.7%.The incidence of IBD 9.8% (219 cases of IBD from 2,234). The ulcerative colitis

(UC) was 192 cases (87.7%) which male gender 44.8%, female 55.2%, and average age 47.8 ± 15.75 years. Crohn’s Disease (CD) was 27 cases (12.3%) which male gender 40.7%, female 59.3%, and average age 40.96 ± 16.24 years. There are significant difference for average age between UC and CD (47.81 ± 15.75 vs 40.96 ± 16.25, selleck chemical p = 0.04). Most of the clinical symptoms are chronic diarrhea 78.6%, then abdominal pain 55%, hematochezia 46.8%, abdominal mass 5% and constipation 5%. Chronic diarrhea was the most of clinical symptoms for UC and CD. Conclusion: The incidence of IBD is still only below 10% from colonoscopy patients.

Most of them are UC. Female was a most gender MCE公司 for both UC and CD. There are significant differences for average age between UC and CD. Key Word(s): 1. Colonoscopy; 2. inflammatory bowel disease Presenting Author: TADAKAZU HISAMATSU Additional Authors: JUN MIYOSHI, KATSUYOSHI MATSUOKA, MAKOTO NAGANUMA, KIYOTO MORI, HIROKI KIYOHARA, KOSAKU NANKI, TOMOHARU YAJIMA, YASUSHI IWAO, HARUHIKO OGATA, TOSHIFUMI HIBI, TAKANORI KANAI Corresponding Author: TADAKAZU HISAMATSU Affiliations: Tokyo Dental College Ichikawa General Hospital, Keio University School of Medicine, Keio University School of Medicine, Keio University School of Medicine, Keio University School of Medicine, Keio University School of Medicine, Keio University School of Medicine, Keio University School of Medicine, Keio University School of Medicine, Kitasato University Kitasato Institute Hospital, Keio University School of Medicine Objective: We evaluated the clinical efficacy of adalimumab (ADA) for Crohn’s disease (CD) and analyzed predictive factors for induction and maintenance of clinical remission. Methods: We retrospectively reviewed the medical records of 45 patients treated with ADA for CD at Keio University Hospital between October 2010 and October 2013. Clinical remission was defined as a Harvey-Bradshaw index of ≤4. Results: Twenty-eight of 45 patients (62.2%) achieved clinical remission at week-4.

13 Furthermore, TGF-β derived from HSCs acted on tumor cells and governed tumorigenesis in a paracrine fashion, leading to tumor-progressive and autocrine TGF-β signaling in tumor cells.18 Recently, stromal cell-derived factor 1 (SDF-1) was found to be released by MK-8669 datasheet activated HSCs within the liver metastases, and CXCR4 (chemokine [C-X-C motif] receptor 4), the ligand of SDF-1, was found to be expressed in colorectal cancer cells.22In

vitro, this SDF-1/CXCR4 paracrine signaling promoted tumor cell invasion and protected tumor cells from apoptosis.22 In unpublished data, we have also demonstrated that myofibroblast-derived PDGF-BB is a potent survival factor for cholangiocarcinoma cells. Taken together, these data support the concept that activated RGFP966 ic50 HSCs promote tumor cell growth by supplying them with growth factors and cytokines. A high degree of ECM remodeling favors tumor invasion and progression in the liver.23 Both MMP and TIMP2 play a key role in degrading basement membranes, thereby allowing cancer cells to cross tissue boundaries and develop into metastases. By performing

in situ hybridization and zymography, Musso et al. found that both MMP2 and TIMP2 messenger RNA were expressed in activated HSCs at the invasive front of liver metastases, and a higher level of MMP2 messenger RNA and enzymatic activity was detected in liver metastases than in nontumoral liver samples.24, 25 In addition, activated 上海皓元医药股份有限公司 HSCs at the invasive front of human liver metastases were found to express a secreted form of ADAM9 (a disintegrin and metallopeptidase 9).16 This molecule was shown to be able to cleave laminin and bind to tumor cells, thus promoting invasion of tumor cells.16 These data indicate that HSCs may facilitate tumor invasion by producing proteolytic enzymes involved in the degradation of ECM. Activated HSCs are a major cell type for ECM production during the pathogenesis of liver fibrosis,4, 5 and this process may

also contribute to the prometastatic growth effects of HSCs. In the liver tumor microenvironment, TGF-β1 released by tumor cells induces HSCs to produce increased amounts of ECM constituents such as fibronectin and collagen I. These ECM components constitute a microenvironment in which tumor cells adhere and grow. In addition to providing a physical support to tumor cells, these ECM components also regulate the adhesion, migration, and survival of tumor cells by binding to and activating integrins on the surface of tumor cells.26, 27 For example, ECM-mediated activation of phosphoinositide 3-kinase and its downstream targets in tumor cells protects tumor cells from genotoxin-induced cell cycle arrest and subsequent apoptosis, contributing to tumor chemoresistance.28 In addition, the poorly vascularized architecture associated with desmoplasia contributes to tumor chemoresistance by imposing a barrier to drug delivery.

[28, 29] A previous study showed that

the 3-year cumulative occurrence rate of liver cancer was 12.5% in cirrhotic patients and 3.8% in chronic hepatitis patients, suggesting that hepatitis B and C virus infection and high AFP values are risk factors.[30] Ascha and colleagues reported that HCC developed in 12.8% of cirrhotic patients with non-alcoholic steatohepatitis (NASH) and 20.3% of cirrhotic patients with hepatitis C virus (HCV) infection (P = 0.03) during a median follow-up period of 3.2 years; the cumulative incidence of HCC was 2.6% per year for NASH-cirrhosis and 4.0% in HCV-cirrhosis (P = 0.09).[31] As for the morphological aspects, a coarse parenchymal echo pattern in the liver is a risk factor for the development of HCC in patients with Nutlin-3a solubility dmso HCV-related cirrhosis.[32] The incidence of HCC differed depending JNK inhibitor library on the echo pattern of liver parenchyma; that is, HCC developed in 9 of 11 (82%) cases with a coarse-nodular pattern, 3 of 7 (43%) with a coarse pattern, and only 1 of 20 (5%) with a fine pattern. The study found that the incidence of a coarse-nodular pattern of liver parenchyma was significantly higher in the high DNA synthesizing group than in the low DNA synthesizing group; thus, increased DNA synthesis by hepatocytes may account for the increased risk of developing HCC. Additionally, hepatic lesions showing hypo-density in both the arterial and equilibrium

phases of contrast-enhanced CT were associated with an annual HCC incidence rate 上海皓元 of 15.8%.[33] This incidence rate was higher than in our study,

a discrepancy that may have been due to the marked differences with respect to lesion characteristics between the studies. The appearance of hepatic lesions in the so-called postvascular phase is based on microbubble accumulation using Sonazoid or Levovist.[10-15] Sonograms of this phase allow us to predict histological findings and to characterize focal hepatic lesions.[2, 6, 7] However, postvascular-phase findings are not specific because PIELs encompass a wide spectrum of hepatic lesions. In particular, PIELs may include well-differentiated HCC in cirrhotic patients, and may present an alternation from non-hypervascular lesion to hypervascular lesion. In our study, three PIELs had an arterial-phase hypervascular appearance, which is strongly suggestive of a malignant lesion. However, these lesions did not change the imaging findings during follow-up, indicating that arterial vascularity may not always be predictive for the development of HCC from a PIEL. The mean diameter of HCC lesions that occurred in our study was 15.1 mm, being sufficient to be cured by local treatment alone.[34] The time interval between HCC detection and the last imaging was 4.0 months, which is considered to be an acceptable duration. In fact, the American Association for the Study of Liver Diseases recommends a 6-month interval for HCC screening in cirrhotic patients.

6%) of the 10 769 commune health stations which provide health services in Viet Nam found that liver cancer is the most common cause of cancer RAD001 death in Viet Nam,6 accounting for 27.1% of cancer deaths (31.04% in men and 19.91% in women).

It is thought that over 90% of these liver cancer deaths reflected the high prevalence of HBV infection in Viet Nam.23 Alcohol and HCV infection are other likely contributors to this high rate of liver cancer. In one study of patients diagnosed with HCC, the majority (85%) had evidence of CHB; almost one in seven patients had evidence of HCV.24 For prevention of liver cancer in Viet Nam, the first long-term focus should be HBV vaccination, thus effecting primary prevention of all liver cancers that are related to this virus. In addition, it will be important to use the best available treatments to profoundly suppress HBV and HCV in the chronically infected to lessen HCC risk. It will also be important to address alcoholic liver disease well before it reaches the stage that can

lead to cancer. There are many challenges that exist in Viet Nam related to providing the type of total integrated approach to liver disease that could substantially decrease both morbidity and mortality. Although 70–75% of Viet Nam’s 84 million people dwell in rural and mountainous regions where medical care is substantially limited, almost all of the 10 769 communes have a health center which provides both primary health care and preventive health-care activities,25 a potentially valuable resource for addressing liver disease. Providing the health centers with simple accurate guides on proper screening and vaccination procedures Olaparib nmr for HBV, screening medchemexpress for HCV, and treatment for those with CHB and CHC could guide them to proper care of liver disease patients. Because these commune health centers already have information flowing to and from the Ministry of Health, a national mandate to improve liver disease services could efficiently reach the local commune level. It will also

be important to enlist private health-care providers as in some areas there are more private providers than public ones.26 The non-profit health organizations that provide health care in Viet Nam are also valuable resources. All provinces and most communes (95.7%) have a Red Cross Society branch that provides free health checks for the poor and other vulnerable groups, including children, the elderly, and women,25 so enlisting their help in the campaign against liver disease might be invaluable. Re-use of contaminated needles, syringes, and inadequately sterilized medical equipment is another major challenge that must be addressed. Recent Vietnamese studies have identified as major risk factors for HBV infection a history of hospitalization and of acupuncture4 as well as a history of surgery.9 HCV prevalence is particularly high in patients on maintenance hemodialysis (54%) and those with hemophilia (29%).

6%) of the 10 769 commune health stations which provide health services in Viet Nam found that liver cancer is the most common cause of cancer see more death in Viet Nam,6 accounting for 27.1% of cancer deaths (31.04% in men and 19.91% in women).

It is thought that over 90% of these liver cancer deaths reflected the high prevalence of HBV infection in Viet Nam.23 Alcohol and HCV infection are other likely contributors to this high rate of liver cancer. In one study of patients diagnosed with HCC, the majority (85%) had evidence of CHB; almost one in seven patients had evidence of HCV.24 For prevention of liver cancer in Viet Nam, the first long-term focus should be HBV vaccination, thus effecting primary prevention of all liver cancers that are related to this virus. In addition, it will be important to use the best available treatments to profoundly suppress HBV and HCV in the chronically infected to lessen HCC risk. It will also be important to address alcoholic liver disease well before it reaches the stage that can

lead to cancer. There are many challenges that exist in Viet Nam related to providing the type of total integrated approach to liver disease that could substantially decrease both morbidity and mortality. Although 70–75% of Viet Nam’s 84 million people dwell in rural and mountainous regions where medical care is substantially limited, almost all of the 10 769 communes have a health center which provides both primary health care and preventive health-care activities,25 a potentially valuable resource for addressing liver disease. Providing the health centers with simple accurate guides on proper screening and vaccination procedures STI571 mouse for HBV, screening MCE for HCV, and treatment for those with CHB and CHC could guide them to proper care of liver disease patients. Because these commune health centers already have information flowing to and from the Ministry of Health, a national mandate to improve liver disease services could efficiently reach the local commune level. It will also

be important to enlist private health-care providers as in some areas there are more private providers than public ones.26 The non-profit health organizations that provide health care in Viet Nam are also valuable resources. All provinces and most communes (95.7%) have a Red Cross Society branch that provides free health checks for the poor and other vulnerable groups, including children, the elderly, and women,25 so enlisting their help in the campaign against liver disease might be invaluable. Re-use of contaminated needles, syringes, and inadequately sterilized medical equipment is another major challenge that must be addressed. Recent Vietnamese studies have identified as major risk factors for HBV infection a history of hospitalization and of acupuncture4 as well as a history of surgery.9 HCV prevalence is particularly high in patients on maintenance hemodialysis (54%) and those with hemophilia (29%).

2 C57BL/6 (B6) mice were purchased from the Jackson LBH589 datasheet Laboratory. TLR9−/− (CD45.2) mice on a B6 background (obtained from S. Akira, Osaka University, Japan) were bred in our

facility. Neutrophil depletion was accomplished with an intraperitoneal injection of 500 μg anti-Ly6G antibody (1A8) or isotype control (RatIgG2a; BioXCell) 24 and 2 hours before I/R. Flow cytometry revealed that this regimen resulted in 100% depletion of CD11bhiLy6G+ neutrophils within the liver, spleen, and bone marrow 24 hours after the second dose. TLR9 blockade was accomplished with a subcutaneous injection of 100 μg inhibitory CpG (iCpG) or control DNA sequence (InvivoGen).15 HMGB1 blockade was achieved by intraperitoneal injection of 50 μg anti-HMGB1 monoclonal antibody

(gift from K.J. Tracey, Manhasset, NY) or mouse IgG2bκ isotype control (Sigma-Aldrich) 1 hour before I/R. Bone marrow chimeric mice were generated using WT (CD45.1) Sirolimus mw and TLR9−/− (CD45.2) mice. T cell–depleted bone marrow cells (5 × 106) were injected intravenously within 2 hours of lethal irradiation (1300 rads) using a 137Cs source. More than 90% of the hematopoietic cells in the spleen were of donor origin 8 weeks later. Serum was obtained by direct cardiac puncture. Animals were maintained in a pathogen-free animal housing facility at Memorial Sloan-Kettering Cancer Center. All procedures were approved by the Institutional Animal Care and Use Committee. A model of segmental (70%) warm hepatic ischemia was used as previously described with minor modifications.7 Briefly, under ketamine (1 mg/mL) and xylazine (1 mg/mL) anesthesia, an upper midline abdominal incision was made and the liver hilum exposed. The vasculature supplying the left and median lobes (ischemic lobes) of the liver was occluded with a microvascular clamp (Roboz Surgical Instruments) for 60 minutes. Evidence of ischemia during the clamping period was confirmed by tissue blanching. After removal of the clamp, evidence of reperfusion was confirmed by immediate color change of the ischemic lobes. Sham mice underwent the same procedure without clamping. Mice were euthanized MCE by carbon dioxide inhalation. Serum ALT was measured using the Olympus

AU400 Chemistry Analyzer. Formalin-fixed liver samples were embedded in paraffin. Five-micron sections were stained with hematoxylin-eosin and examined with an Axioplan 2 widefield microscope (Zeiss). Liver nonparenchymal cells (NPCs) and bulk splenocytes were isolated as previously described.16 Bulk CD45+ hematopoietic cells were isolated from liver NPCs using immunomagnetic beads (Miltenyi Biotec) as per the manufacturer’s instructions. WT hepatocytes were separated from NPCs after in situ perfusion with collagenase (type IV, 1 mg/mL; Sigma-Aldrich) and gentle mechanical disruption of liver tissue. This was followed by five cycles of centrifugation (50g for 2 minutes) in which the hepatocytes were separated from the supernatant. Hepatocyte purity exceeded 90% as assessed by light microscopy.

To prevent postpartum haemorrhage after delivery, women Palbociclib datasheet routinely receive oxytocin,

which also causes fluid retention. Administration of DDAVP, combined with litres of fluids and oxytocin, may result in life-threatening hyponatraemia [70]. A single dose of DDAVP immediately prior to epidural catheter placement in labour, however, has not been associated with adverse events [71]. Among the published series of VWD in pregnancy there are multiple cases of postpartum haemorrhage that occurred despite prophylaxis [18]. In a review of published cases of women with VWD who experienced postpartum haemorrhage, Roque et al. [72] determined that the average time of haemorrhage was 15.7 ± 5.2 days after delivery. The implication is that women with bleeding disorders may require more frequent evaluation. Thus, weekly contact is suggested during the postpartum period [73]. Prophylaxis, when indicated, may be required for two or more weeks. More data are required to determine Fludarabine datasheet optimal length of prophylaxis. Data on the management of women with bleeding disorders are hampered by a lack of randomized trials, case-control studies or even large case series. No one centre sees a large

number of patients. Severe bleeding disorders are rare and women with milder disease may not come to the attention of a haemostasis centre or even be diagnosed. Funding for studies is limited. In the absence of strong evidence to direct

practice, government agencies and haemophilia organizations have developed consensus guidelines. There are at least nine sets of guidelines published by the government agencies or haemophilia organizations that specifically address women with bleeding disorders. The guidelines were reviewed and summarized in 2009 and found to be remarkably congruent [74]. The good news is that there MCE公司 is consensus regarding many of the issues pertaining to the management of women with bleeding disorders. “
“Summary.  The development of inhibitors to the infused factor in patients with haemophilia is a serious clinical problem. Recent evidence suggests that alongside the strong genetic contribution to inhibitor formation, there are a number of non-genetic factors – perceived by the immune system as danger signals – which promote formation of inhibitors. This study provides a comprehensive review of clinical studies relating to these factors and also presents a survey of opinion concerning their importance and clinical influence, conducted among the members of the European Haemophilia Treatment Standardisation Board (EHTSB).

When Tac is used in the therapy of UC patients, it is desirable to confirm the genetic polymorphisms of CYP3A5 in patients if possible. At the very least, it is necessary to understand Kinase Inhibitor Library that the percentage of patients achieving the optimal trough level in the early period of therapy and the short-term clinical outcome will differ in CYP3A5 Exp and Non-Exp cases. The authors have no funding interests with respect to this article. Toshiyuki Matsui received a research grant from Eisai Co., Ltd, Mochida Pharmaceutical Co., LTD., Glaxo Smith Kline K.K., and Mitsubishi Tanabe Pharma

Corporation.; Toshiyuki Matsui received lecture fees from Eisai Co., Ltd. “
“Chronic diarrhea is a common and a challenging problem for clinicians. The differential diagnosis is vast and a systematic approach is required. Precise diagnosis should be achievable in most patients with true diarrhea. Acute or chronic diarrhea, osmotic or secretory diarrhea, large-volume or small-volume diarrhea, bloody or non-bloody diarrhea, and associated features will help to Selleckchem CP-690550 narrow down the investigations, so that the wide range of investigations available are not used in a haphazard manner. “
“Nonalcoholic fatty

liver disease (NAFLD) is becoming an important chronic liver disorder in Asia. Prevalence figures show regional variations but at least 10% of the general population in Asia have fatty liver. Fatty liver can develop with relatively small changes in weight

(2–3 kg), often with increasing central adiposity. The metabolic syndrome may precede or follow NAFLD. Overt diabetes is present in one-third of cases but when oral glucose tolerance tests are performed, a further medchemexpress third of individuals have impaired glucose tolerance or diabetes. Natural history data are still scarce but cases of advanced hepatic fibrosis and hepatocellular carcinoma are now regularly reported. Many cases of cryptogenic cirrhosis are also attributable to NAFLD. Histological progression has been demonstrated for patients with NASH as well as for those with hepatic steatosis alone. Genetic factors may in part contribute to the rise in NAFLD. Polymorphisms within apolipoprotein C3 (APOC3) gene have been linked to NAFLD in lean Indian men. Although a number of other polymorphisms involving genes controlling adipose distribution, insulin signalling, adipokine responses and hepatic fibrosis have been reported, these studies have been underpowered. Transient elastography could help in detecting and monitoring hepatic fibrosis but further refinements in technique are necessary for obese individuals. Of the biomarkers, hyaluronic acid and cytokeratin-18 fragment testing show promise as markers of hepatic fibrosis and NASH, respectively. Lifestyle alterations including dietary changes and increased physical activity remain the cornerstone of management.

Results: 1. The raw rhubarb group had 334 cases, among which 159 were males and 175 were females. The patients ranged in age from 16 to 88, with the average age of 59.8 years. There were 252 cholelithiasis, 44 cholangiocarcinoma, 1 biliary fistula, 37 other cases. There were 3 PEP cases (0.898%). There were no obviously adverse reactions after

taking raw rhubarb soak. 2. The control group had 335 cases, among which 156 were males and 179 were females. The patients ranged in age from 11 to 90, Fluorouracil clinical trial with the average age of 55.3 years. There were 269 cholelithiasis, 39 cholangiocarcinoma, 3 biliary fistula, 24 other cases. There were 13 PEP cases (3.90%). 3. There were no significant difference in age and gender between two groups. The incidence Selleckchem INK-128 of PEP in rhubarb group is significant

lower than that in control group (P < 0.05). Conclusion: Raw Rhubarb could significantly reduce the incidence of PEP. It deserved clinical use. Key Word(s): 1. Raw Rhubarb; 2. PEP; 3. ERCP; Presenting Author: YADONG FENG Additional Authors: WENFANG CHEN, SHUNFU XU, HONG ZHU, JINLIANG NI, BIN XIAO, XIAOXIN CHEN Corresponding Author: XIAOXIN CHEN Affiliations: First Affiliated Hospital of Nanjing Medical University Objective: To evaluate the efficacy and feasibility of selective endoscopic stenting for unresectable malignant hilar strictures. MCE Methods: Data from 57 patients who received endoscopic stengting for unresectable malignant hilar strictures between January 2005 and June 2011 were retrospectively reviewed. All enrolled patients were received unilateral or bilateral stent insertion. Clinical characters, technique success, drainage success, stent types, palliation drainage, complications, stent patency and survival were analyzed. Results: 48 patients underwent unilateral stent insertion. Nine cases received

bilateral stent insertion. Technique success rates of planned unilateral and bilateral drainage were 100% (41/41) and 56.25% (9/16). PS and SEMS were applied in 32 and 25 patients. Total successful drainage was 51. Bilateral stent insertion was more frequently performed in patients with higher Bismuth stage. No significant difference in use of stent and successful drainage between different Bismuth types. The median patency time and survival was longer in SEMS. Complications mostly occurred in patients who received bilateral drainage with advanced Bismuth classification. Conclusion: Endoscopic stenting is a feasible option for unresectable malignant hilar strictures. It should be performed by skilled expertises. Key Word(s): 1. Hilar malignancy; 2. Selective drainage; 3.

At the Mayo Clinic, country selleck inhibitor of birth and primary language information was available to allow Somali patients to be identified. A control group of age and gender-matched patients was identified from the remaining non-Somali patients. Clinical data such as HCV treatment, reasons for lack of treatment, sustained virologic response (SVR) rates, and laboratory values were collected and the two groups were compared. Results: We identified 145 Somali patients

and 145 non-Somali controls that were age and gender-matched. Although Somali patients were offered treatment at similar rates as non-Somali patients, a larger percentage of them declined treatment (n=24; 17% vs 7; 5%). The most significant barrier to treatment was refusal of liver biopsy (11; 8% vs 1; 1%). Fear of side effects was also treatment limiting for 6% of the Somali patients who were treatment candidates. Overall, 58% of Somali patients who were treatment candidates underwent treatment vs. 75% of non-Somalis. Of the patients that underwent treatment, rates of SVR were similar (26% of Somalis vs 23% of non-Somalis). Although treatment limiting comorbidities were similar in both groups, the non-Somali population had more ongoing alcohol and intravenous drug use. Conclusions: We did not find significant differences in access to treatment, but fewer Somali patients accepted treatment.

The most significant barriers to accepting treatment for Somalis FK506 were refusal of a liver biopsy and fear of treatment side effects. When the Somali patients were treated, their rates of SVR were similar to the non-Somali population. It is

essential for healthcare providers to find interventions aimed at reducing the barriers to treatment and increasing acceptance of HCV treatment. In the era of interferon-free regimens and increasing use of noninvasive methods to assess liver fibrosis, we anticipate that Somali patient outcomes will continue to improve. Disclosures: Lewis R. Roberts – Grant/Research Support: Bristol Myers Squibb, ARIAD Pharmaceuticals, BTG, Wako Diagnostics, Inova Diagnostics, Gilead Sciences Mohamed A. Hassan – Speaking and Teaching: GILEAD The following people medchemexpress have nothing to disclose: Esther Connor, Albert Ndzengue, Nasra H. Giama, Jeremiah Menk, Essa A. Mohamed, Saleh Elwir BACKGROUND: Sub-saharan Africa (SSA) is reported to have one of the highest global rates of HCV infection, accounting for nearly 20% of all global cases. However, reports suggesting a high rate of serologic false positive cases have led to uncertainty regarding the true burden of HCV infection in this region. METHODS: We conducted a case-control study of prior blood donors at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana to identify appropriate screening strategies and determine rates of active infection.