Occult hepatitis C virus infection among haemodialysis patients

Ali, Naiema K.; Mohamed, Ragaa R.; Saleh, Bothina E.; Alkady, Manal M; Farag, Eman S.

doi:10.1016/j.ajg.2018.09.001

Cited by 10 publications

(5 citation statements)

References 26 publications

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“…Literature defined two different forms of OCI; the cryptogenic form in which patients have no anti-HCV antibodies, and the secondary form in which patients have anti-HCV antibodies and had cleared HCV infection either spontaneously or after therapy 11,12. The assessment of OCI among patients who received antiviral regimens was investigated in many clinical scenarios; such as in patient with spontaneously cleared virus,13 in hemodialysis patients,14 in liver transplant settings,15 and also in patients with treatment-induced SVR, but data in this context were conflicting, with some studies finding genomic and anti-genomic HCV-RNA in PBMCs,1 while others did not 2. The presence of post-treatment viral particles in patients with SVR may carry a potential risk for disease relapse, disease progression, and/or a hidden re-infection foci that may affect the disease epidemiologic pattern and distribution.…”

Section: Introductionmentioning

confidence: 99%

<p>Prevalence and predictors of occult hepatitis C virus infection among Egyptian patients who achieved sustained virologic response to sofosbuvir/daclatasvir therapy: a multi-center study</p>

Mekky¹,

Sayed²,

Abdelmalek³

et al. 2019

IDR

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BackgroundOccult hepatitis C virus (HCV) infection (OCI) is characterized by the detection of HCV-RNA in non-serum reservoirs, such as peripheral blood mononuclear cells (PBMCs) and/or hepatocytes with undetectable HCV-RNA or antibodies in the serum. In this study, we tried to evaluate the prevalence and possible predictors of OCI in patients who achieved sustained virologic response (SVR) post sofosbuvir/daclatasvir (SOF/DCV) therapy.Patients and methodsA cross-sectional multicenter study was designed to enroll 1,280 HCV-infected patients who received SOF (400 mg) plus DCV (60 mg) once daily ± ribavirin regimen for 12 weeks and achieved SVR 12 weeks post treatment. They were randomly recruited from three dedicated Egyptian centers for management of HCV. Real-time PCR was performed to detect HCV-RNA in serum and PBMCs and to evaluate the different risk factors pertaining to the existence of OCI.ResultsHCV-RNA was detected in PBMCs of 50 (3.9%) of them. All OCI cases exhibited significant fibrosis score and raised pre-treatment alanine aminotransferase (ALT) levels. Logistic regression analysis comparing OCI with non-OCI revealed that high pre-treatment viral load, raised ALT, advanced fibrosis score, prolonged prothrombin time, low albumin, Child B score, antiviral experienced patients, and raised bilirubin are the most significant predictor for the possibility of OCI presence with Odds Ratio as 7.03, 5.13, 4.4, 2.68, 2.52, 1.9, 1.5, and 1.2, respectively.ConclusionIn spite of its remote possibility, OCI post SOF/DCV therapy may be present in some cases, and this may entail a re-auditing for the definition of SVR by dual testing in both serum and PBMCs.

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Section: Introductionmentioning

confidence: 99%

<p>Prevalence and predictors of occult hepatitis C virus infection among Egyptian patients who achieved sustained virologic response to sofosbuvir/daclatasvir therapy: a multi-center study</p>

Mekky¹,

Sayed²,

Abdelmalek³

et al. 2019

IDR

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“…However, blood transfusion has been previously associated with higher prevalence of OCI. 33,42,43 Among the risk factors, hypertension was the most prominent risk factor observed among the studied CHD patients (67.5%), followed by diabetes (50.8%), blood transfusion (47.5%), and history of endoscopy (45%). Furthermore, some of these conditions have been previously described to be in association with other bloodborne pathogens in the region of study.…”

Section: Discussionmentioning

confidence: 95%

“…Among the two OCIs identified, one had 49 IU/mL viral load while the other had no detectable viral load, which is in accordance with most previous studies, 21,32,[34][35][36] although some studies have found higher titers. 33 This observation can be explained by the probable underlying mechanisms of OCI: low levels of infected hepatocytes, specific CD markers in immune responses, and memory T cell activation, which all can be involved in the suppressed status of HCV replication to a very low or undetectable levels. 37 It has been determined that low copies of HCV as few as 20 copies can be transmitted and be infectious, 38 where HCV can be potentially infectious in surfaces for at least 16 hours.…”

Section: Discussionmentioning

confidence: 99%

Occult Hepatitis C Virus Infection among Hemodialysis Patients: An Iranian Experience

2020

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Background: Patients with chronic kidney failure and those undergoing chronic hemodialysis (CHD) treatment are at high risk of infection with hepatitis C virus (HCV). The incidence of occult HCV infection (OCI) in CHD remains controversial and the real burden of HCV in this population may be affected by the rate of OCI. This study evaluates the molecular assessment of OCI in CHD in an Iranian population. Methods: All subjects on CHD in the South Khorasan province of Iran were invited for participation in the study. Whole blood samples were taken and serological, clinical, and demographic information was recorded. HCV-RNAs were checked in serum and peripheral blood mononuclear cells (PBMCs) using an in-house semi-nested PCR assay. Viral load was determined using a real-time PCR-based quantification kit. Sequencing was performed to determine genotypes. Results: Overall, 120 cases participated in the study; 57.5% were male and the rest were female. In serum samples, no positive case was found for HCV-RNA. In PBMC samples, 2/120 (1.6%) were positive for HCV-RNA (95% CI, 0.002 to 0.059); the mean age of OCI positive cases was 37.5 ± 19.2 years which was significantly lower than OCI negative cases (P = 0.026). Only one case had detectable viral load which was 49 IU/mL. The only HCV genotype identified was 1a. Conclusion: This study showed that there is a risk of OCI among CHD patients; the very low and undetectable viral loads of OCI warrant further follow-up molecular testing for earlier diagnosis and treatment in the era of DAA.

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“…The current practice for screening hepatitis C infection is done by anti-HCV antibodies in immunocompetent individuals and by serum HCV RNA level detection in immunocompromised persons/patients on chemotherapy/hemodialysis. 1 Anti-HCV antibodies are taken as a marker of present or past infection (resolved spontaneously or on antiviral therapy). 2 Occult hepatitis C virus infection (OCI) has been defined considering exposure and clearance of the virus from the host body.…”

Section: Discussionmentioning

confidence: 99%

Acute Hepatitis in an Immunosuppressed Patient: A Dilemma

Gupta¹

2023

Euroasian Journal of Hepato-Gastroenterology

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A bstract Acute hepatitis in patients on chemotherapy has always been challenging. Demystifying the truth becomes essential to continue chemotherapy. Wepresent a case of carcinoma buccal mucosa who developed acute hepatitis following a single dose of cisplatin and radiotherapy. In the background of a history of chronic alcoholism, and alcohol abstinence of more than 3 months, acute alcoholic hepatitis was unlikely. Though he had occult hepatitis B with HBsAg negative and positive IgG anti-HBc antibody status, however, with undetectable HBV DNA PCR quantitative, hepatitis B was unlikely to be the cause of acute hepatitis. With all viral markers including atypical viruses and autoimmune work-up being negative, it was a real-time challenge to find the exact cause. How to cite this article Gupta T. Acute Hepatitis in an Immunosuppressed Patient: A Dilemma. Euroasian J Hepato-Gastroenterol 2023;13(1):26–27.

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Occult hepatitis C virus infection among haemodialysis patients

Cited by 10 publications

References 26 publications

<p>Prevalence and predictors of occult hepatitis C virus infection among Egyptian patients who achieved sustained virologic response to sofosbuvir/daclatasvir therapy: a multi-center study</p>

<p>Prevalence and predictors of occult hepatitis C virus infection among Egyptian patients who achieved sustained virologic response to sofosbuvir/daclatasvir therapy: a multi-center study</p>

Occult Hepatitis C Virus Infection among Hemodialysis Patients: An Iranian Experience

Acute Hepatitis in an Immunosuppressed Patient: A Dilemma

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