HCV persistence: Cure is still a four letter word

Feld, Jordan J.; Liang, T. Jake

doi:10.1002/hep.20561

Cited by 27 publications

(20 citation statements)

References 24 publications

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“…These results contrast with those from studies that reported the detection of HCV RNA in the PBMC of spontaneously resolved and treatment-induced aviremic subjects. [20][21][22] These authors speculated that persistent HCV RNA in PBMC may reflect the presence of a long-lived HCV reservoir [20][21][22] (reviewed by Feld and Liang 19 ). The difference with our results may be due to the more stringent definition of plasma aviremia used here.…”

Section: Discussionmentioning

confidence: 99%

“…[15][16][17][18] The continued presence of viral RNA in the PBMC of subjects who had either spontaneously cleared their plasma viremia or cleared viremia following antiviral therapy has recently been reported, raising concerns that PBMC may serve as a long-lived HCV reservoir capable of rekindling systemic infection. [19][20][21][22] In this study, plasma and corresponding PBMC were prepared from recalled confirmed HCV-seropositive blood donors who had tested either HCV RNA-positive or HCV RNA-negative in their original index donation. The presence of plasma viremia was tested for using a highly sensitive transcription-mediated amplification (TMA) assay.…”

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confidence: 99%

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Clearance of hepatitis C virus RNA from the peripheral blood mononuclear cells of blood donors who spontaneously or therapeutically control their plasma viremia

et al. 2008

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We determined whether hepatitis C virus (HCV) RNA could be detected associated with peripheral blood mononuclear cells (PBMC) of seropositive blood donors who had spontaneously or therapeutically cleared their plasma viremia. Blood donor plasma viremia status was first determined with a highly sensitive transcription-mediated amplification (TMA) test performed in duplicate assays. PBMC from 69 aviremic and 56 viremic blood donors were then analyzed for the presence of HCV RNA with TMA adapted to detect viral RNA in PBMC and with a reverse transcription-nested polymerase chain reaction assay. PBMCassociated HCV RNA was detected in none of the 69 aviremic donors, including all 6 subjects with a sustained viral response following antiviral therapy. PBMC-associated HCV RNA was detected in 43 of the 56 viremic donors. The 13 viremic donors with no detectable PBMCassociated HCV RNA all had very low viral loads (6 positive only in 1 of 2 duplicate plasma TMA assays, 6 with viral loads below 100 HCV RNA copies/mL, and 1 with a viremia of 2700 HCV RNA copies/mL). The absence of detectable PBMC HCV RNA detection in all 69 aviremic donors reported here contrasts with prior studies, possibly as a result of the higher sensitivity of the TMA assay used to test for plasma viremia. Conclusion: Our results indicate that PBMC are unlikely to serve as a long-lived reservoir of HCV in aviremic subjects.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Clearance of hepatitis C virus RNA from the peripheral blood mononuclear cells of blood donors who spontaneously or therapeutically control their plasma viremia

et al. 2008

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“…This is an important point that we have been making for some time based on the report made by Pham et al [10], in which the authors found replicating viral particles up to five years after the SVR had been achieved. This finding has recently been corroborated in similar studies and in a Hepatology editorial entitled "HCV persistence: cure is still a four-letter word" [11], in which, despite of the lack of a fully-formed notion of the meaning of such persistence, the authors highlight the obvious impact that patients representing perpetual sources of HCV dissemination would have on public health, as well as the potential increased incidence of hepatocarcinoma.…”

Section: Viral Response Typesmentioning

confidence: 62%

Hepatitis C treatment: shorter and better?

Araújo¹,

Courtouké²,

Barone³

2007

Braz J Infect Dis

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Herein, we present a synthesis of two publications that evaluate an abbreviated therapeutic approach to treating chronic hepatitis C virus (HCV) infection. Based on those publications, we discuss the use of the early virologic response (EVR) as a tool for the optimized management of patients under treatment, as well as reviewing concepts of HCV viral kinetics. The fourth-week EVR, characterized by HCV RNA dropping to undetectable levels, allows individuals infected with HCV genotype 1 and presenting low baseline viral loads to be treated with the combination of pegylated interferon and ribavirin for 24 weeks, whereas individuals infected with HCV genotypes 2 or 3 can be treated for only 12 weeks. Therefore, by adopting abbreviated treatment regimens optimized through early prediction of sustained viral response, it is possible to increase the number of patients treated without incurring the excess costs related to high rates of treatment failure and management of adverse outcomes, as well as avoiding the risks of unnecessarily exposing patients to drugs that have the potential to be highly toxic.

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“…Gelişmiş tarama prosedürlerine rağmen anti-HCV antikorları saptanamayan hemodiyaliz hastalarında yeni tarama stratejilerinin geliştirilmesi gerekliliği açıktır. HCV infeksiyonunun patogenezini araştıran çalışmalar HCV'nin ekstrahepatik alanda replike olduğunu ve gizli infeksiyon yaptığını kanıtlamıştır (10,11,23). Özellikle HCV infeksiyonu açısından yüksek risk altındaki hemodiyaliz hastalarında yapılacak olan kapsamlı araştırmalar, bu hasta grubunda gerçek HCV infeksiyonu prevalansının saptanmasına olanak sağlayacağı gibi moleküler testlerin rutin kullanıma girmesi, diyaliz makinelerinin ortak kullanımı konusundaki tartışmalara yol gösterecek ve tedavi indikasyonlarının net olarak belirlenmesine olanak sağlayacaktır.…”

Section: İrdelemeunclassified

“…Bulaşma sonrası spontan olarak iyileşen, ancak anti-HCV pozitifliği devam eden hemodiyaliz hastaları HCV infeksiyonu olanlara ayrılmış diyaliz makinelerinde diyalize alınırlarsa reinfeksiyon riskine sahip olurlar. Periferik kandaki mononükleer hücrelerde (PKMNH) viral RNA replikasyonu devam eden gizli ("occult") HCV infeksiyonu olan hastalar transfüzyon veya hemodiyaliz uygulamaları sırasında virusun yayılması açısından potansiyel risk oluştururlar (10,11).…”

Section: Introductionunclassified

Frequency and Epidemiologic Characteristics of Hepatitis C Virus Infection in Patients Receiving Hemodialysis in Our Region

Bozkurt¹,

Aygen²,

Yıldız³

et al. 2012

Klimik Dergisi

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ÖzetAmaç: Hepatit C virusu (HCV) hemodiyalize giren hasta popülas-yonunda sık görülen bir infeksiyon etkenidir. Çalışmada bölge-mizdeki hemodiyaliz hastalarında HCV infeksiyonunun sıklığının ve epidemiyolojik özelliklerinin araştırılması amaçlanmıştır. Yöntemler: Çalışmaya rutin olarak hemodiyalize giren 16 yaşın üzerindeki kronik böbrek yetmezliği olan 100 hasta alındı. Hastaların demografik verileri, HCV için olası bulaşma yolları, hemodiyalize giriş yolu, hemodiyaliz süresi, karaciğer fonksiyon testleri, hepatit göstergeleri ve HCV RNA sonuçları araştırıldı. Hepatit göstergeleri "enzyme immunoassay" (EIA, Abbott Architect, Almanya) ile test edildi. Plazmada HCV RNA "real time" polimeraz zincir reaksiyonu (PZR, COBAS TaqMan Roche, Almanya) ile araştırıldı. PZR testinin ölçüm aralığı 25-3.91x10 8 İÜ/ ml, duyarlılığı ise 25 İÜ/ml idi. Bulgular: Hastaların yaş ortalaması 58.6±13.9 yıldı ve %56'sı erkekti. Ortalama diyaliz süresi 4.8±3.9 (1-19) yıl bulundu. Alanin aminotransferaz ve aspartat aminotransferaz değerleri ortalaması sırasıyla 17±1.1 İÜ/lt ve 16.1±7.2 İÜ/lt idi. En sık bulaşma yolu cerrahi girişim, ikinci sıklıkla kan transfüzyonu olarak saptandı. Çalışmaya dahil edilen 100 hastanın 16'sında anti-HCV ve HCV RNA testlerinden en az biri pozitifti. Hastalardan 10'unda anti-HCV pozitifliği, 11'inde HCV RNA pozitifliği belirlendi. Anti-HCV'si pozitif olan 10 hastadan 5'inin HCV RNA'sı pozitif bulundu. Anti-HCV'si negatif olan 90 hastanın 6 (%6.7)'sında HCV RNA pozitifti. Bu hastaların HCV RNA değerleri 75-338 İÜ/lt arasındaydı. AbstractObjective: Hepatitis C virus (HCV) is a common cause of infection in patients receiving hemodialysis. In this study, we aimed to determine frequency and epidemiological characteristics of HCV infection in hemodialysis patients. Methods: One hundred patients with end-stage renal disease, over 16 years old, receiving hemodialysis were enrolled in this study. Demographic data, possible routes of transmission, type of vascular access, duration of hemodialysis, liver function tests, markers of hepatitis and HCV RNA were all evaluated. Serological markers were tested with enzyme immunoassay (EIA, Abbott Architect, Germany). HCV RNA was studied by using real-time polymerase chain reaction (PCR, COBAS TaqMan Roche, Germany). Measurement range of the PCR test was 25-3.91x10 8 IU/mL and the sensitivity of the test was 25 IU/mL. Results: The mean age of the patients was 58.5±13.9 years and 56% were male. The average duration of dialysis was 4.8±3.9 (1-19) years. The mean levels of aspartate aminotransferase and alanine aminotransferase were 17±1.1 IU/L and 16.1±7.2 IU/L, respectively. Surgical procedures and blood transfusion were the most common route of transmission. Of the 100 patients, 16 were positive for at least one of anti-HCV and HCV RNA. 10 out of 100 patients were positive for anti-HCV and 11 were positive for plasma HCV RNA. Five of the 10 patients whose anti-HCV results were positive were also found to be positive for HCV RNA. Six (6.7%) out of 90 anti-HCV-negative patien...

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HCV persistence: Cure is still a four letter word

Cited by 27 publications

References 24 publications

Clearance of hepatitis C virus RNA from the peripheral blood mononuclear cells of blood donors who spontaneously or therapeutically control their plasma viremia

Clearance of hepatitis C virus RNA from the peripheral blood mononuclear cells of blood donors who spontaneously or therapeutically control their plasma viremia

Hepatitis C treatment: shorter and better?

Frequency and Epidemiologic Characteristics of Hepatitis C Virus Infection in Patients Receiving Hemodialysis in Our Region

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