Prevalence of occult HCV infections in Saudi patients who achieved sustained virologic response with direct acting antiviral treatment

Al Ashgar, Hamad; Al Quaiz, Mohammed; Al Kahtani, Khalid; AlQahtani, Ahmed; Alhussaini, Hussa; Elssadany, Amr M; Alqahtani, Saleh A; PEEDIKAYIL, MUSTHAFA

doi:10.21608/mjvh.2020.125595

Prevalence of occult HCV infections in Saudi patients who achieved sustained virologic response with direct acting antiviral treatment

Document Type : Original article

Authors

¹ Medicine, Gastroenterology dept., King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia

² Infection and Immunity dept., Research Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia

³ Anatomic pathology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia

⁴ Radiology dept., King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia

⁵ Consultant hepatologist, King Faisal Specialist Hospital and Research Centre. Riyadh. Saudi Arabia.

⁶ KING FAISAL SPECIALIST HOSPITAL AND RESEARCH CENTER,PO BOX NO.3354

10.21608/mjvh.2020.125595

Abstract

Background: Occult hepatitis C virus (HCV) infection (OCI) is a condition where HCVRNA is present in hepatocytes or peripheral blood mononuclear cells (PBMCs), but not in the serum, in patients treated for hepatitis C infection. Serum HCV ant-ibodies may or may not be present. Aim: We investigated the prevalence of OCI in PBMCs and hepatocytes in patients who had achieved sustained virologic response (SVR) after 24 weeks of direct-acting antiviral treatment. Methods: Chronic HCV patients with Genotype 1a and 4 who achieved SVR24 weeks after treatment with direct-acting antiviral agents (DAAs) were prospectively selected. RNeasy Blood and Tissue Kit (Qiagen GmbH, Germany) was used for RNA extraction from blood and liver tissue samples. Superscript IV First-Strand Synthesis System (Invitrogen) was used for reverse transcription PCR. Quantitative and qualitative detection of HCV RNA was performed using pri-mers specific to the 5′untranslated region (5′UTR). Patients: Of the six chronic HCV patients recruited for this study, five were infected with genotype 4 and one with genotype 1a. Five patients were treated with Sofosbuvir and Daclatasvir, and one patient with Ledipasvir plus Sofosbuvir. All of the patients were immunocompetent. Results: None of the pat-ients had detectable HCV RNA in either the PBMCs or hepatocytes, suggesting zero prevalence of OCI in patients who achieved 24 weeks SVR post DAA treatment. Conclusion: We failed to detect HCV RNA in both the hepatocytes and PBMCs of all patients recruited for the study. This finding suggests that OCI is a rare phenomenon in chronic HCV patients with SVR following DAAs.

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