References of "Gerard, Christiane"
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See detailA clinical lab experience with an automated HIV Antigen/Antibody (Ag/Ab) combined assay
HUYNEN, Pascale ULg; TOUSSAINT, Françoise ULg; GERARD, Christiane ULg et al

Poster (2014, May 11)

OBJECTIVES: To describe the diagnostic performance of a new fourth-generation HIV Ag/Ab chemiluminescent immunoassay, available on the new LIAISON® XL analyser, in a clinical setting. METHODS: Through ... [more ▼]

OBJECTIVES: To describe the diagnostic performance of a new fourth-generation HIV Ag/Ab chemiluminescent immunoassay, available on the new LIAISON® XL analyser, in a clinical setting. METHODS: Through February 2012-October 2013, 12,438 samples of serum, received at our laboratory for screening for HIV infection were routinely tested with LIAISON® XL Murex HIV Ab/Ag assay (HIV-XL), which employs HIV-1, HIV-1 group O, and HIV-2 antigens and anti-p24 monoclonal antibodies in two coupled reagent cartridges, providing information of the overall Ab/Ag reactivity and detail of the specific reactivity for anti-HIV/HIV p24 antigen. Each serum with positive result or with negative result displaying a value close to the cut-off were sent to the regional AIDS-Reference Laboratory (RefLab) to perform confirmatory assays (PCR, Immunoblot). A previous verification of the HIV-XL demonstrated 100% sensitivity with a challenge panel of hundred positive sera provided by the RefLab. Performed external quality control was from United-Kingdom National External Quality Assessment Service (NEQAS). RESULTS: Out of the clinical samples, 12,312 non-reactive samples (including 6 negative results displaying a value close to the cut-off further confirmed true HIV negative), 64 Ab HIV reactive samples (all confirmed HIV-1 positive by immunoblot), including 4 samples reactive also for Ag HIV (confirmed positive by Ag assay/PCR), 42 Ab HIV reactive samples tested negative by immunoblot, and 20 Ag HIV reactive samples tested negative by the kit used for the Ag p24 detection in our HIV Reference Lab, have been found. All the 43 NEQAS specimens tested, 16 reactive and 27 non-reactive, were correctly classified. These results, considered all together, provide a calculated positive predictive value of 57.5% with an estimated specificity of 99.5% (with 95% confidence interval of 99.36-99.62%), and a calculated negative predictive value of 100% with an estimated sensitivity of 100.0% (with 95% confidence interval of 95.49-100%). CONCLUSIONS: In our experience HIV-XL showed excellent performance associated to all the advantages of a fully automated/random access instrument. [less ▲]

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See detailUn allèle KEL*02mod responsable d'une exclusion apparente de maternité
MONFORT, Mélanie ULg; PEYRARD, Thierry; ARNAUD, Lionel et al

in Transfusion Clinique et Biologique (2013), 20

The patient’s rare KEL:1,-2 phenotype was highlighted in course of a routine preoperative erythrocyte typing. Unexpectedly, her two daughters presented a KEL:-1,2 phenotype what appeared first as an ... [more ▼]

The patient’s rare KEL:1,-2 phenotype was highlighted in course of a routine preoperative erythrocyte typing. Unexpectedly, her two daughters presented a KEL:-1,2 phenotype what appeared first as an apparent maternity exclusion. Flow cytometry, genotyping and adsorption-elution analyses were then performed for those 3 patients. KEL genotyping showed that the patient’s genotype was KEL*01/KEL*02 whereas that of her daughters was KEL*02/KEL*02. By using polyclonal anti-KEL2 reagent, weak amount of KEL2 was identified on the patient’s erythrocytes, a result which was confirmed by both flow cytometry and adsorption-elution assays, suggesting that patient’s phenotype was in fact KEL:1,2w. These results are in favour of a weak expressed KEL*02 allele (KEL*2mod) transmission coding for a KEL2 antigen detected in some technical conditions only. Those results allowed to explain the apparent maternity exclusion based on initial KEL phenotype. This study also seems to confirm the presence of a compensatory mechanism of the KELmod allele deficient expression in heterozygote patients. A KEL phenotype retrospective study of 80.000 subjects showed a local KEL:1,-2 frequency four times lower than that described in literature. Moreover, a significant number of those individuals would in reality be KEL:1,2w, what still would decrease the real frequency of the KEL:1,2 subjects. [less ▲]

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See detailBLOOD GROUPS, HEMOGLOBIN PHENOTYPES AND CLINICAL DISORDERS OF CONSANGUINEOUS YANSI POPULATION
Munlemvo Mavanga, Nana ULg; BOEMER, François ULg; SEIDEL, Laurence ULg et al

in World Journal of Hematology (2013), 2(4), 109-114

AIM To study frequency of blood groups, prevalence of sickle-cell anemia trait and glucose-6-phosphate dehydrogenase deficiency, among consanguineous Yansi tribe. METHODS A total of 525 blood samples were ... [more ▼]

AIM To study frequency of blood groups, prevalence of sickle-cell anemia trait and glucose-6-phosphate dehydrogenase deficiency, among consanguineous Yansi tribe. METHODS A total of 525 blood samples were collected, of which 256 among the Yansi population, and 269 for the unrelated control group in the Bandundu province of Democratic Republic of Congo. Blood group antigens were determined in the following systems: ABO, Rh, Kell, Duffy, Kidd and MNS. Blood grouping and extended phenotype tests were performed according to standard immunohematological procedures. Spot tests and tandem mass spectrometry were used respectively for the assessment of glucose-6-phosphate dehydrogenase deficiency and sickle-cell anemia trait. RESULTS The frequency of ABO phenotypes conformed to the following order O>A>B>AB with notably 62.5, 23.8, 12.1 and 1.6% for the Yansi, and 54.6, 27.5, 14.1 and 3.7% for the unrelated control group, respectively (P=0.19). As for the Rh phenotypes, the most frequent were ccD.ee, ccD.Ee, CcD.ee, corresponding to 71.5, 12.1 and 12.1% for the Yansi, and 70.6, 15.6 and 8.2%, for the unrelated control group (P=0.27). The frequency of MN and Ss phenotypes were statistically different between groups (P=0.0021 and P=0.0006). G6PD deficiency was observed in 11.3% of subjects in the Yansi group, and in 12.4% of controls (P = 0.74). The sickle-cell anemia trait was present in 22.4% of Yansi subjects and 17.8% in the control group (P=0.24). Miscarriages and deaths in young age were more common among Yansi people. CONCLUSION This study shows a significant difference in MNS blood group distribution between the Yansi tribe and a control population. The distribution of other blood groups and the prevalence of hemoglobinopathies did not differ in the Yansi tribe. [less ▲]

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See detailRISK OF RED BLOOD CELL ALLOIMMUNISATION IN RWANDA : ASSESSMENT OF PRETRANSFUSION CROSSMATCH TECHNIQUES USED IN DISTRICT HOSPITALS
NDAHIMANA, E; GOTHOT, André ULg; GERARD, Christiane ULg et al

in East African Medical Journal (2013), 90(8), 277-282

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See detailEpidemiological profiles of human immunodeficiency virus and hepatitis C virus infections in Malian women: risk factors and relevance of disparities
Bouare, N; GOTHOT, André ULg; DELWAIDE, Jean ULg et al

in World journal of hepatology (2013), 27(5), 196-205

AIM: To document the epidemiologic patterns and risk factors of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections in Mali in order to develop prevention means for both diseases ... [more ▼]

AIM: To document the epidemiologic patterns and risk factors of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections in Mali in order to develop prevention means for both diseases. METHODS: Two prospective studies were conducted in Bamako in 2009 among 1000 pregnant women (i.e. , young women) who consulted six reference health centers, and in 2010, among 231 older women who attended general practice in two hospitals. Antibody tests and molecular analysis (performed only for HCV) were used to quantify the frequencies of both infections. The data were collected from patients recruited through a questionnaire. Transmission risk factors of both diseases were identified by univariate and multivariate analysis. RESULTS: HCV seroprevalence was 0.2% for young and 6.5% for older women. HIV prevalence was similar in both populations (4.1% vs 6.1%). In older women, the analysis of risk factors highlighted an association between HCV infection and episodes of hospitalization (P < 0.01). The study did not show an association between HIV infection and the variables such as hospitalization, transfusion, tattoo, dental care, and endoscopy. A significant decrease of HIV seroprevalence was detected in young women who used condoms for contraception more than for other purposes (P < 0.01). By contrast, HIV seroprevalence was significantly increased in young women using condoms mainly to prevent sexual infections rather than for contraception (P < 0.01). No HCV/HIV coinfection was detected in our study. CONCLUSION: Risk factors and epidemiologic data of HIV and HCV as well as the absence of co-infection strongly suggest epidemiological disparities between these diseases. [less ▲]

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See detailPrevalence of HIV and HCV infections in two populations of Malian women and serological assays performances
Bouare, Nouhoum; VAIRA, Dolorès ULg; GOTHOT, André ULg et al

in World Journal of Hepatology (2012), 4(12), 365-73

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See detailAbout the diagnosis of acute transfusion-related reaction during cardiopulmonary bypass
ERPICUM, Marie ULg; BLAFFART, Francine ULg; DEFRAIGNE, Jean ULg et al

Conference (2012, September 29)

Many advances have been realized in the field of blood safety during the last decade: donors’ selection, leukoreduction of packed red blood cells and platelet concentrates, genomic screening of blood ... [more ▼]

Many advances have been realized in the field of blood safety during the last decade: donors’ selection, leukoreduction of packed red blood cells and platelet concentrates, genomic screening of blood-borne diseases, viral and bacterial inactivation process,... However, transfusion of blood components remains unsafe. Therefore, detecting and reporting transfusion-related complications are still essential means for both the patients’ management and the public health approach, since these measures help to adjust preventive measures to be applied in a haemovigilance purpose. Most acute transfusion-related complications occur within minutes or hours after transfusion and require urgent medical care; delayed transfusion reactions may also develop days, even months later, implying a longer follow-up. Transfusion of red blood cells is not infrequent during cardiac surgery with cardiopulmonary bypass. Symptoms of acute transfusion-related reactions include hypotension, diffuse bleeding, hemoglobinuria and oliguria. These symptoms are identical to those that can be observed during a complicated cardiopulmonary bypass. Consequently, identification of acute transfusion-related reactions in this particular situation is quite difficult and probably leads to an under-reporting of their occurrence. In this paper, we explore how to track acute transfusion-related reactions during cardiopulmonary bypass. Any suspicion of such reactions must leads to investigations, in order to confirm the diagnosis. Their detection would allow to better focus their specific treatment and further their notification in a global blood safety policy. [less ▲]

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See detailPoly(2-dimethylamino ethylmethacrylate)-Based Polymers To Camouflage Red Blood Cell Antigens
Cerda Cristerna, Bernardino Isaac ULg; COTTIN, Sophie ULg; Flebus, Luca ULg et al

in Biomacromolecules (2012), 13(4), 1172-1180

Poly(2-dimethylamino-ethylmethacrylate) (PDMAEMA) is a cationic polymer when dissolved in a 7.4 pH fluid. Owing to its ionic nature, this polycation interacts with the negatively charged cell membrane ... [more ▼]

Poly(2-dimethylamino-ethylmethacrylate) (PDMAEMA) is a cationic polymer when dissolved in a 7.4 pH fluid. Owing to its ionic nature, this polycation interacts with the negatively charged cell membrane surface of red blood cells (RBCs). The electrostatic self-assembly of PDMAEMA on RBCs membrane can be employed for inducing the formation of a polymeric shield camouflaging blood group antigens on RBCs as a valuable strategy for developing “universal RBCs” for blood transfusion. The purpose of this research was to evaluate the camouflaging ability of PDMAEMA homopolymers and PDMAEMA-copoly(nethylene glycol) copolymers differing in molecular weight and architecture. Surprisingly, the PDMAEMAs caused a partially masking, no masking, and sensitization of the same RBCs population. The MW and architecture of the polymers as well as temperature of PDMAEMA-RBCs treatment influenced the results observed. Herein, the very particular reactivity of PDMAEMAs and RBCs is analyzed and discussed. [less ▲]

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See detailHCV screening in African (Malian) women : relevancy of the HCV NS3 epitope
BOUHARE, NOUHOUM; VAIRA, Dolorès ULg; GOTHOT, André ULg et al

Poster (2012)

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See detailStudy of HCV and HIV infections in Mali: Comparative Epidemiology and Risk Factors
BOUHARE, NOUHOUM; VAIRA, Dolorès ULg; GOTHOT, André ULg et al

Poster (2012)

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See detailMaladie hémolytique néonatale modérée
KEUTGENS, Aurore ULg; MONFORT, Mélanie ULg; WAGEMANS, Danielle et al

in Revue Médicale de Liège (2012), 67(7-8), 403-406

A Caucasian woman, with a A+ CCD.ee K neg erythrocyte phenotype and no history of blood transfusion, delivered a first child who developed mild anemia. The direct antiglobulin test performed on the ... [more ▼]

A Caucasian woman, with a A+ CCD.ee K neg erythrocyte phenotype and no history of blood transfusion, delivered a first child who developed mild anemia. The direct antiglobulin test performed on the newborn red blood cells belonging to the A+ CCD.ee K neg group, was strongly positive for IgG. During the pregnancy and after the delivery, the woman had a negative irregular antibody screening test, using standard red blood cells. However, at birth, using a collection of thawed red blood cells with rare phenotypes (private antigens), the lab showed an antibody anti-Wra in the maternal serum. The activity of the maternal antibody, with a titer of 16, was completely inhibited by dithiothreitol, indicating the nature IgM of the circulating antibody. The presence of the antigen Wra on the surface of the newborn and its biological father red blood cells was confirmed. The concentration of IgG anti-Wra on baby erythrocytes was demonstrated by the presence of the antibody anti-Wra in the eluate. This case illustrates the difficulties to detect antibodies against private antigens on baby erythrocytes, responsible of hemolytic diseases of newborn. Indeed, standard red blood cell panels used for irregular antibodies screening test do not express generally those private antigens. [less ▲]

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See detailEvolution over a 15 year period of the epidemiological profile of 2884 newly diagnosed HCV patients in Belgium.
LOLY, Jean ULg; GERARD, Christiane ULg; VAIRA, Dolorès ULg et al

in Acta Gastro-Enterologica Belgica (2011, March), 74

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See detailHepatitis C of genotype 2: the role of medical invasive exams.
Putzeys, V.; GERARD, Christiane ULg; Bastens, B. et al

in Acta gastro-enterologica Belgica (2011), 74(2), 277-80

BACKGROUND AND AIM: Hepatitis C virus genotype 2 is the third in order of frequency in Belgium. The aim of this study was to better define the genotype 2 carriers' epidemiology characteristics. METHODS ... [more ▼]

BACKGROUND AND AIM: Hepatitis C virus genotype 2 is the third in order of frequency in Belgium. The aim of this study was to better define the genotype 2 carriers' epidemiology characteristics. METHODS: In a database comprising 1726 viremic hepatitis C virus patient from the south part of Belgium, the files of 98 genotype 2 carriers were reviewed. RESULTS: There was a strong association between genotype 2 and the mode of transmission. The rate of contamination by invasive medical exams was very high (23%), and statistically different from the one of the others genotypes. Eligibility for antiviral therapies and the rate of sustained viral response were high. CONCLUSION: HCV genotype 2 was highly associated with transmission by invasive medical exams. [less ▲]

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See detailEffet de la deleucocytation des concentres erythrocytaires sur les reactions transfusionnelles.
Mukagatare, I.; MONFORT, Mélanie ULg; de Marchin, J. et al

in Transfusion clinique et biologique : journal de la Societe francaise de transfusion sanguine (2010), 17(1), 14-9

SUBJECT: In order to assess the impact of leukocyte reduction, all transfusion reactions reported at Liege Teaching Hospital's Blood Bank 2 years before and after the implementation of universal leukocyte ... [more ▼]

SUBJECT: In order to assess the impact of leukocyte reduction, all transfusion reactions reported at Liege Teaching Hospital's Blood Bank 2 years before and after the implementation of universal leukocyte reduction of red blood cells concentrates which started-up on 1 January 2005 were evaluated. STUDY DESIGN AND METHODS: A retrospective analysis of transfusion reactions from 1 January 2003 to 31st December 2006 was undertaken. Data were collected from computerized reports, which were entered as soon as a transfusion reaction was reported. Symptoms were classified in different reaction's categories. Blood cultures, antibody screening and direct antiglobulin test were performed. Differences between the two time periods, before (2003-2004) and after (2005-2006) universal leukoreduction were determined by the Chi-square test and significance was defined as a p value less than 0.05. RESULTS: During period before the implementation of systematic leukoreduction, 68.7% of red blood cells transfused were leukoreduced. A total of 365 transfusion reactions in 91,996 red blood cells units transfused (0.4%) were reported, of which 266 were classified as febrile non-hemolytic transfusion reactions (72.9%), followed by allergic reactions (7.1%) and miscellaneous reactions (3.8%). When comparing the two-time periods, the rate of all transfusion reactions in general significantly decreased from 0.49 to 0.31% (p<0.001). Therefore, universal leukocyte reduction significantly reduced the rates of febrile non-hemolytic transfusion reactions (0.35% versus 0.24%; p=0.002) and allergic reactions (0.05% versus 0.01%; p<0.001). CONCLUSION: Universal leukocyte reduction significantly reduced the rate of transfusion reactions. [less ▲]

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See detailRh D foeto-maternal alloimmunization prophylaxis with anti-D immunoglobulins reviewed in the era of foetal RHD genotyping.
Minon, J. M.; Gerard, Christiane ULg; Schaaps, Jean-Pierre ULg et al

in Acta Clinica Belgica (2009), 64(3), 195-202

In Belgium, prevention of anti-D immunization is currently based on systematic postnatal prophylaxis associated with targeted antenatal injection in high-risk situations of foeto-maternal haemorrhage.The ... [more ▼]

In Belgium, prevention of anti-D immunization is currently based on systematic postnatal prophylaxis associated with targeted antenatal injection in high-risk situations of foeto-maternal haemorrhage.The failures of prevention are mainly due to the non-respect of established guidelines for RhlG prophylaxis, and to spontaneous undetected foetal-maternal haemorrhages without any obvious cause during the third trimester of pregnancy. In order to reduce the rate of residual post-pregnancy anti-D immunization, several countries decided to associate the classical prophylaxis to a routine antenatal anti-D prophylaxis (RAADP) during the 28th or 29th week of gestation. Since a few years, the foetal RHD genotyping in maternal plasma enables us to limit the antenatal prophylaxis only to those D- women carrying a D+ foetus. This paper deals with: the advantages of an antenatal prevention in the light of non-invasive foetal RHD genotyping, the rules rendering prevention protocols efficient whatever the algorithm applied, and the recommended immuno-haematology follow-up of women who received RhlG. [less ▲]

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See detailRoutine Fetal Rhd Genotyping with Maternal Plasma: A Four-Year Experience in Belgium
Minon, J. M.; Gerard, Christiane ULg; Senterre, J. M. et al

in Transfusion (2008), 48(2), 373-81

BACKGROUND: The objective was to evaluate the diagnostic value of RHD fetal genotyping from the plasma of D- mothers as soon as 10 weeks' gestation in a routine clinical practice in Belgium. STUDY DESIGN ... [more ▼]

BACKGROUND: The objective was to evaluate the diagnostic value of RHD fetal genotyping from the plasma of D- mothers as soon as 10 weeks' gestation in a routine clinical practice in Belgium. STUDY DESIGN AND METHODS: A prospective study was conducted between November 2002 and December 2006. DNA extraction was performed in an automated closed tube system. Fetal RHD/SRY genotypes were detected in the plasma of 563 pregnant mothers by real-time polymerase chain reaction (PCR) targeting multiple exons 4, 5, and 10 of the RHD gene and targeting an SRY gene sequence. These were compared to the D phenotypes determined in the 581 babies they delivered. RESULTS: By combining amplification of three exons, the concordance rate of fetal RHD genotypes in maternal plasma and newborn D phenotypes at delivery was 100 percent (99.8% including one unusual false-positive). The presence of nonfunctional RHD genes and the absence of a universal fetal marker, irrespective of fetal sex, did not influence the accuracy of fetal RhD status prediction. The RHD genotyping from 18 twin pregnancies was also assessed. Five weak D women were excluded from the RHD fetal genotyping prediction. Three discrepant results (0.5%) between predicted fetal genotype and cord blood phenotype were not confirmed by the baby phenotypes from venipuncture blood. CONCLUSION: Prenatal prediction of fetal RHD by targeting multiple exons from the maternal plasma with real-time PCR is highly sensitive and accurate. Over 4 years, this experience has highly modified our management of D- pregnant women. [less ▲]

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See detailPrevalence de l'infection par le VIH chez les femmes enceintes. Etude en milieu rural africain.
Mathe, M Kirere; Rigo, Jacques ULg; Sontag, Danièle et al

in Revue d'Epidémiologie et de Santé Publique (2008), 56(6), 407-13

BACKGROUND: The goal of the study is to assess the prevalence and risk factors of HIV in pregnant women in the North-East rural area of the Democratic Republic of Congo. METHODS: We undertook an ... [more ▼]

BACKGROUND: The goal of the study is to assess the prevalence and risk factors of HIV in pregnant women in the North-East rural area of the Democratic Republic of Congo. METHODS: We undertook an exploratory study on women attending the antenatal care during the study period (from December 2002 to December 2004) in the referral General hospital of the health catchments' area of Oicha (DRC). Women with gestational age equal or above 36 weeks were included in the study. After a first test using rapid test Abbott Determine locally, a second crossing check was performed in the referral HIV laboratory in Liege (Belgium). RESULTS: Among 5016 participants tested, 94 were positive (prevalence of 1.9% [CI95% 1.5-2.5]). Following factors predict a risk of being positive among participants: the statute of displacement (OR: 5.77; IC95%: 3.59-9.29); widowhood and divorces (OR: 4.47; IC95%: 1.47-13.60); mobility related to the profession of the husband (OR: 4.00; IC95%: 2.36-6,75); living the countryside (OR: 1.67; IC95%: 1.06-2.62; p: 0.0258). [less ▲]

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See detailNouvelles strategies dans la prise en charge de l'allo-immunisation foeto-maternelle anti-RHD (Rhesus)
Minon, J. M.; Gerard, Christiane ULg; Dricot, J. F. et al

in Revue Médicale de Liège (2006), 61(11), 756-62

Despite generalisation of anti-D immunoprophylaxis, RhD allo-immunisation still remains the major cause of severe haemolytic disease of the fetus and of the newborn (HDFN). The routine follow up of ... [more ▼]

Despite generalisation of anti-D immunoprophylaxis, RhD allo-immunisation still remains the major cause of severe haemolytic disease of the fetus and of the newborn (HDFN). The routine follow up of pregnant women comprises: the ABO/D, Rh/Kell red cells typing and the search for irregular antibodies. In case of anti-D immunisation, the paternal Rh phenotype, when known, provides useful information regarding the probability for the fetus to have inherited the D antigen and thereby to be exposed to the risk of HDFN. The antibody titre, which is predictive of possible in vivo haemolysis, must be interpreted in the light of the previous obstetric history, and can lead to the decision of invasive amniocentesis. Then the measurement of the optical density (deltaOD450 nm) and the fetal RhD typing can be realised on amniotic fluid. New molecular techniques make it possible now to demonstrate the presence of fetal DNA in maternal plasma. These methods lying on non invasive procedures could advantageously be applied to the genotyping of fetal RHD during pregnancy. The present paper aims to discuss the predictive values of RHD fetal genotype in maternal plasma of RhD negative mothers. The ante-partum management of immunised pregnant women is reviewed in the light of this new molecular approach combined to Doppler ultrasonography of the fetal middle cerebral artery. This non invasive method for determining fetal RHD genotype could be systematically proposed to all RhD negative pregnant women for a better targeted prenatal follow-up and an increased efficacy of RhD prophylaxis. [less ▲]

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See detailHCV genotype 4 in Belgium: three distinct patterns among patients from European and African origin
Delwaide, Jean ULg; Reenaers, Catherine ULg; Gerard, Christiane ULg et al

in European Journal of Gastroenterology & Hepatology (2006), 18(7), 707-712

Background Considered uncommon in western countries some years ago, hepatitis C virus of genotype 4 is now spreading in some areas of Europe. This is assumed to be due to immigration from a region of high ... [more ▼]

Background Considered uncommon in western countries some years ago, hepatitis C virus of genotype 4 is now spreading in some areas of Europe. This is assumed to be due to immigration from a region of high prevalence for this genotype and to propagation among drug users. In the south of Belgium, genotype 4 currently accounts for 10% of hepatitis C virus patients and its prevalence is increasing with time. Objective To better define the genotype 4 carriers' characteristics. Methods In a database comprising 1726 viraemic hepatitis C virus patients, the files of 85 genotype 4 carriers were reviewed. Results Beside the African (58%) and European drug user (15%) subgroups classically described, a third subgroup consisting of European nondrug users (26%) was identified as peculiar: these patients were older, had been mostly contaminated sporadically, presented a great diversity of subtypes, and were mainly of Italian origin. In this subgroup, contamination was supposed to be ancient, having occurred probably in Italy before immigration into Belgium. By contrast, European drug users were infected with only two subtypes (4c/4d and 4), an observation in favour of recent spread. Africans had a great diversity of subtypes, were young, and were mostly contaminated sporadically in their home countries. Despite their epidemiological differences, the clinical management, and in particular the rates of eligibility for treatment, were similar for these three groups. Conclusions Three different patterns of genotype 4 carriers were observed, corresponding to three different spreading profiles. They did not induce, however, different clinical management. [less ▲]

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