Detection of Occult Hepatitis C Virus Infection in Patients Who Achieved a Sustained Virologic Response to Direct-Acting Antiviral Agents for Recurrent Infection After Liver Transplantation

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• 作者：Sandra Elmasry¹ ; Sanya Wadhwa¹ ; Bo-Ram Bang¹ ; Linda Cook² ; ³ ; Shefali Chopra⁴ ; Gary Kanel⁴ ; Brian Kim¹ ; Tammy Harper¹ ; Zongdi Feng⁵ ; Keith R. Jerome² ; ³ ; Jeffrey A. Kahn¹ ; ^§ ; ; ^{jkahn@usc.edu} ; Takeshi Saito¹ ; ⁴ ; ⁶ ; ^§ ; ; ^{saitotak@usc.edu}
• 关键词：Viral Hibernation ; Treatment Outcome ; Persistence ; Limit of Detection
• 刊名：Gastroenterology
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：152
• 期：3
• 页码：550-553.e8
• 全文大小：1933 K
• 卷排序：152

文摘

Occult infection with hepatitis C virus (HCV) is defined as the presence of the HCV genome in either liver tissue or peripheral blood monocytes, despite constant negative results from tests for HCV RNA in serum. We investigated whether patients who maintained a sustained virologic response 12 weeks after therapy (SVR12) with direct-acting antiviral (DAA) agents for recurrent HCV infection after liver transplantation had occult HCV infections. We performed a prospective study of 134 patients with recurrent HCV infection after liver transplantation who were treated with DAAs, with or without ribavirin, from 2014 through 2016 (129 patients achieved an SVR12). In >10% of the patients who achieved SVR12 (n = 14), serum levels of aminotransferases did not normalize during or after DAA therapy, or they normalized transiently but then increased sharply after DAA therapy. Of these 14 patients, 9 were assessed for occult HCV infection by reverse transcription quantitative polymerase chain reaction. This analysis revealed that 55% of these patients (n = 5) had an occult infection, with the detection of negative strand viral genome, indicating viral replication. These findings indicate the presence of occult HCV infection in some patients with abnormal levels of serum aminotransferases, despite SVR12 to DAAs for HCV infection after liver transplantation.