Volume 1, Issue 3 , Pages 185-189, December 2011
Occult Hepatitis C Virus Infection and Its Relevance in Clinical Practice
Article Outline
Hepatitis C virus (HCV) can persist in the liver, lymphoid (immune) cells, and serum of individuals long after an apparently complete therapy-induced or a spontaneous resolution of hepatitis C. This essential asymptomatic infection, called secondary occult HCV infection (OCI), usually occurs in anti-HCV antibody reactive individuals with normal liver function tests. This infection has been identified when the nucleic acid amplification assays of enhanced sensitivity were applied for the detection of HCV genome and its replication. In addition to the secondary OCI, a form of low-level HCV-RNA-positive infection of unknown etiology coinciding with moderately elevated serum liver enzymes and progressing in the absence of anti-HCV detectable by standard clinical assays has been reported. Because of its undefined origin, it can be termed cryptogenic OCI. In this review, the general characteristics of OCI, the ways of its detection and associated controversies, and the potential clinical implications of its existence will be concisely outlined.
Keywords: Clinical practice , hepatitis C , identification of OCI , occult HCV infection
Abbreviations: CHC, chronic hepatitis C , HBV, hepatitis B virus , HCC, hepatocellular carcinoma , HCV, hepatitis C virus , IFN, interferon , IU, international unit , NAH, nucleic acid hybridization , OCI, occult HCV infection , PBMC, peripheral blood mononuclear cells , PCR, polymerase chain reaction , RBV, ribavirin , RNA, ribonucleic acid , SVR, sustained virological response
No full text is available. To read the body of this article, please view the PDF online.
References
- . Natural history of hepatitis C . J Hepatol . 1999;31:17–24
- . Extrahepatic replication of HCV: insights into clinical manifestations and biological consequences . Hepatology . 2006;44:15–22
- In vivo tropism of hepatitis C virus genomic sequences in hematopoietic cells: influence of viral load, viral genotype, and cell phenotype . Blood . 1998;91:3841–3849
- Productive replication of hepatitis C virus in perihepatic lymph nodes in vivo: implications of HCV lymphotropism . Gastroenterology . 2006;130:1107–1116
- Hepatitis C virus replicates in the same immune cell subsets in chronic hepatitis C and occult infection . Gastroenterology . 2008;134:812–822
- Infection of peripheral mononuclear blood cells by hepatitis C virus . J Hepatol . 1992;15:382–386
- . De novo infection and propagation of wild-type Hepatitis C virus in human T lymphocytes in vitro . J Gen Virol . 2006;87:3577–3586
- . Hepatitis C virus persisting after clinically apparent sustained virological response to antiviral therapy retains infectivity in vitro . Hepatology . 2009;49:1431–1441
- . Hepatitis C virus infects T cells and affects interferon-gamma signaling in T cell lines . Virology . 2007;361:161–173
- Replication of hepatitis C virus in B lymphocytes (CD19+) . Blood . 1999;94:1138–1139
- . Hepatitis C virus replicates in the liver of patients who have a sustained response to antiviral treatment . Clin Infect Dis . 2006;43:1277–1283
- Long-term follow-up of previous hepatitis C virus positive nonresponders to interferon monotherapy successfully retreated with combination therapy: are they really cured? . Am J Gastroenterol . 2006;101:1811–1816
- . Hepatitis C virus persistence after spontaneous or treatment-induced resolution of hepatitis C . J Virol . 2004;78:5867–5874
- Persistence of hepatitis C virus in patients successfully treated for chronic hepatitis C . Hepatology . 2005;41:106–114
- Occult hepatitis C virus infection in patients in whom the etiology of persistently abnormal results of liver-function tests is unknown . J Infect Dis . 2004;189:7–14
- . Clinical, virologic, histologic, and biochemical outcomes after successful HCV therapy: a 5-year follow-up of 150 patients . Hepatology . 2009;49:729–738
- Sustained virological response is associated with clearance of hepatitis C virus RNA and a decrease in hepatitis C virus antibody . Liver Int . 2009;29:511–517
- . No evidence of occult hepatitis C virus (HCV) infection in serum of HCV antibody-positive HCV RNA-negative kidney-transplant patients . Transpl Int . 2010;23:594–601
- Occult hepatitis C virus infection revisited with ultrasensitive real-time PCR assay . J Clin Microbiol . 2008;46:2106–2108
- Occult hepatitis C virus infection in Iranian patients with cryptogenic liver disease . J Med Virol . 2011;83:989–995
- . Detection of occult hepatitis C and hepatitis B virus infections from peripheral blood mononuclear cells . Immunol Invest . 2010;39:284–291
- . Occult hepatitis C virus infection: what does it mean? . Liver Int . 2010;30:502–511
- . Hepatitis C virus persistence after sustained virological response to antiviral therapy in patients with or without past exposure to hepatitis B virus . J Viral Hepat . 2011; (published online March 1, 2011).
- . Mitogen-induced upregulation of hepatitis C virus expression in human lymphoid cells . J Gen Virol . 2005;86:657–666
- Clinical and therapeutic implications of hepatitis C virus compartmentalization . Gastroenterology . 2006;131:76–84
- Frequent compartmentalization of hepatitis C virus variants in circulating B cells and monocytes . Hepatology . 2004;39:817–825
- Absence of occult HCV infection in patients under immunosuppressive therapy for oncohematological diseases . Hepatology . 2011;54:1487–1489
- . Presence of HCV-RNA after ultracentrifugation of serum samples during the follow-up of chronic hepatitis C patients with a sustained virological response may predict reactivation of hepatitis C virus infection . Aliment Pharmacol Ther . 2009;30:477–486
- . Advances in the molecular diagnosis of hepatitis C and their clinical implications . Mayo Clin Proc . 2001;76:911–920
- Long-term follow-up of chronic hepatitis C patients with sustained virological response to various forms of interferon-based anti-viral therapy . Aliment Pharmacol Ther . 2006;23:507–511
- Pathological and virological findings in patients with persistent hypertransaminasaemia of unknown aetiology . Gut . 2000;47:429–435
- Histological changes in HCV antibody-positive, HCV RNA-negative subjects suggest persistent virus infection . Hepatology . 2008;48:1737–1745
- Predictors of patient and graft survival following liver transplantation for hepatitis C . Hepatology . 1998;28:823–830
- . Reemergence of hepatitis C virus after 8.5 years in a patient with hypogammaglobulinemia: evidence for an occult viral reservoir . J Infect Dis . 2005;192:1088–1092
- . Immune suppression leading to hepatitis C virus re-emergence after sustained virological response . J Med Virol . 2008;80:1720–1722
- . Effect of pretransplant hepatitis C virus RNA status on posttransplant outcome . Transplant Proc . 2008;40:1449–1455
- Recurrence of HCV infection in a sustained responder after chemotherapy for non-Hodgkin's lymphoma: successful retreatment . Am J Med Sci . 2008;336:73–76
- Development of hepatocellular carcinoma in patients with chronic hepatitis C who had a sustained virological response to interferon therapy: a multicenter, retrospective cohort study of 1124 patients . Liver Int . 2007;27:186–191
- Characteristics of patients with chronic hepatitis C who develop hepatocellular carcinoma after a sustained response to interferon therapy . Cancer . 2004;101:1616–1622
- Long term clinical outcome of chronic hepatitis C patients with sustained virological response to interferon monotherapy . Gut . 2004;53:1504–1508
- Sustained virologic response and clinical outcomes in patients with chronic hepatitis C and advanced fibrosis . Ann Intern Med . 2007;147:677–684
- Estimating progression to cirrhosis in chronic hepatitis C virus infection . Hepatology . 2001;34:809–816
- Occult hepatitis C virus infection in type II mixed cryoglobulinaemia . J Viral Hepat . 2003;10:455–459
- Antiviral therapy in patients with occult HCV infection . Hepatology . 2005;42:658A
- Statements from the Taormina expert meeting on occult hepatitis B virus infection . J Hepatol . 2008;49:652–657
PII: S0973-6883(11)60130-8
doi:10.1016/S0973-6883(11)60130-8
© 2011 INASL. Published by Elsevier Inc. All rights reserved.
Volume 1, Issue 3 , Pages 185-189, December 2011
