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A New Twist to a Chronic HCV Infection: Occult Hepatitis C.

Attar BM, Van Thiel D - Gastroenterol Res Pract (2015)

Bottom Line: Purpose.Data Synthesis.Careful longitudinal followup utilizing highly sensitive assays and unique approaches to viral isolation are needed.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology and Hepatology, Cook County Health and Hospitals System, 1901 West Harrison Street, Chicago, IL 60612, USA ; Rush University Medical Center, Chicago, IL 60612, USA.

ABSTRACT
Background. The prevalence of occult hepatitis C infection (OCI) in the population of HCV-RNA negative but anti-HCV positive individuals is presently unknown. OCI may be responsible for clinically overt recurrent disease following an apparent sustained viral response (SVR) weeks to years later. Purpose. To review the available current literature regarding OCI, prevalence, pathogenic mechanisms, clinical characteristics, and future directions. Data Sources. Searching MEDLINE, article references, and national and international meeting abstracts for the diagnosis of OCI (1990-2014). Data Synthesis. The long-term followup of individuals with an OCI suggests that the infection can be transient with the loss of detectable HCV-RNA in PPBMCs after 12-18 months or alternatively exist intermittently and potentially long term. The ultimate outcome of HCV infection is decided by interplay between host immune responses, antiviral therapies, and the various well-identified viral evasion mechanisms as well as the presence of HCV infection within extrahepatic tissues. Conclusion. The currently widely held assumption of a HCV-cure in individuals having had "SVR" after 8-12 weeks of a course of DAA therapy as recently defined may not be entirely valid. Careful longitudinal followup utilizing highly sensitive assays and unique approaches to viral isolation are needed.

No MeSH data available.


Related in: MedlinePlus

Prevalence of OCI in patients with chronic lymphoproliferative disorders (LPD). OCI was detected in 20% of the LPD group versus 4% in controls, adapted from [103].
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fig1: Prevalence of OCI in patients with chronic lymphoproliferative disorders (LPD). OCI was detected in 20% of the LPD group versus 4% in controls, adapted from [103].

Mentions: An intriguing additional question is what is the relationship between the existence of an OCI and the subsequent development of either a lymphoproliferative disease [69] or cryoglobulinemia [70, 71]? Youssef et al. [72] investigated the occurrence of OCI in Egyptian patients with variety of lymphoproliferative disorders (LPDs) (Figure 1). Their study included 100 subjects consisting of 50 consecutive cases with a newly diagnosed lymphoproliferative disease and 50 healthy anti-HCV negative controls. 13 of the 50 (26%) with an LPD group were positive for anti-HCV and all were HCV-RNA positive as well. HCV-RNA was detected in PBMC in 18 of the 50 LPD patients (36%). Importantly, ten of these 18 cases were negative for both anti-HCV and HCV-RNA in their serum and therefore represented true cases of OCI. In the healthy anti-HCV negative controls, the HCV-positive (genomic) strand was found in PBMC in 2 (4%) of those studies thereby fulfilling the criteria for an OCI. The HCV genotype in all 12 cases of OCI was genotype 4, the predominant genotype present in Egypt [72].


A New Twist to a Chronic HCV Infection: Occult Hepatitis C.

Attar BM, Van Thiel D - Gastroenterol Res Pract (2015)

Prevalence of OCI in patients with chronic lymphoproliferative disorders (LPD). OCI was detected in 20% of the LPD group versus 4% in controls, adapted from [103].
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4495183&req=5

fig1: Prevalence of OCI in patients with chronic lymphoproliferative disorders (LPD). OCI was detected in 20% of the LPD group versus 4% in controls, adapted from [103].
Mentions: An intriguing additional question is what is the relationship between the existence of an OCI and the subsequent development of either a lymphoproliferative disease [69] or cryoglobulinemia [70, 71]? Youssef et al. [72] investigated the occurrence of OCI in Egyptian patients with variety of lymphoproliferative disorders (LPDs) (Figure 1). Their study included 100 subjects consisting of 50 consecutive cases with a newly diagnosed lymphoproliferative disease and 50 healthy anti-HCV negative controls. 13 of the 50 (26%) with an LPD group were positive for anti-HCV and all were HCV-RNA positive as well. HCV-RNA was detected in PBMC in 18 of the 50 LPD patients (36%). Importantly, ten of these 18 cases were negative for both anti-HCV and HCV-RNA in their serum and therefore represented true cases of OCI. In the healthy anti-HCV negative controls, the HCV-positive (genomic) strand was found in PBMC in 2 (4%) of those studies thereby fulfilling the criteria for an OCI. The HCV genotype in all 12 cases of OCI was genotype 4, the predominant genotype present in Egypt [72].

Bottom Line: Purpose.Data Synthesis.Careful longitudinal followup utilizing highly sensitive assays and unique approaches to viral isolation are needed.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology and Hepatology, Cook County Health and Hospitals System, 1901 West Harrison Street, Chicago, IL 60612, USA ; Rush University Medical Center, Chicago, IL 60612, USA.

ABSTRACT
Background. The prevalence of occult hepatitis C infection (OCI) in the population of HCV-RNA negative but anti-HCV positive individuals is presently unknown. OCI may be responsible for clinically overt recurrent disease following an apparent sustained viral response (SVR) weeks to years later. Purpose. To review the available current literature regarding OCI, prevalence, pathogenic mechanisms, clinical characteristics, and future directions. Data Sources. Searching MEDLINE, article references, and national and international meeting abstracts for the diagnosis of OCI (1990-2014). Data Synthesis. The long-term followup of individuals with an OCI suggests that the infection can be transient with the loss of detectable HCV-RNA in PPBMCs after 12-18 months or alternatively exist intermittently and potentially long term. The ultimate outcome of HCV infection is decided by interplay between host immune responses, antiviral therapies, and the various well-identified viral evasion mechanisms as well as the presence of HCV infection within extrahepatic tissues. Conclusion. The currently widely held assumption of a HCV-cure in individuals having had "SVR" after 8-12 weeks of a course of DAA therapy as recently defined may not be entirely valid. Careful longitudinal followup utilizing highly sensitive assays and unique approaches to viral isolation are needed.

No MeSH data available.


Related in: MedlinePlus