Hepatitis C “true” late relapse beyond 48 weeks of sustained virologic response after direct acting antiviral therapy

Repeated Hepatitis C Virus Recurrence in a Patient With a Prognosis of Ultimate Spontaneous Clearance: Relapse or Reinfection?

“…22 In addition, the incidence of late relapse is exceedingly low, and the duration is mostly within 12–24 weeks after ending anti-HCV therapy, 5 whereas a number of cases can relapse after 24 weeks. 8,23–27 A viral reservoir persisting in hepatocytes, lymphocytes, and macrophages for years post-SVR also provides the possibility of late relapse. 23,24,28 Among liver transplantation patients, late relapse could be explained by extrahepatic reservoirs of HCV and the high immunosuppressive therapy.…”

Very late relapse of hepatitis C virus infection immediately after liver transplant

“…Late HCV relapses in the era of DAA are very rare because most late relapses have been described after IFN‐based antiviral therapy . Sarrazin et al showed that all patients with late relapse after DAA treatment had HCV genotype 3a .…”

HCV very late relapse following an atypical viral kinetics in a HIV patient treated for hepatitis C with direct-acting antivirals

“…Distinction between reinfection and relapse is essential to establish further therapeutic strategies in such patients, although it might be difficult to be performed in routine clinical practice and therefore many cases might be misclassified. To date, only three cases of "true" very late relapse (i.e., taking place after SVR 48) have been described in HCV-monoinfected individuals with liver cirrhosis, who were probably treated for a suboptimal period of time [8][9][10]. In those patients, reinfection was ruled out by means of sequencing viral genomes when recurrent viremia was observed 62, 72 and 78 weeks after EOT, respectively.…”