Secondary Occult Hepatitis C Virus Infection (HCV) in Chronic HCV Patients after Treatment with Sofosbuvir and Daclatasvir

Khadr, Nashwa; Nouh, Hanan; Hanafi, Nesrine Fathi; Asser, Sara; Hussain, Yousra A.

doi:10.20546/ijcmas.2018.701.165

Cited by 5 publications

(5 citation statements)

References 22 publications

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“…Abd Alla et al reported a high prevalence of OCI among treatment experienced and naive cases 23. Also, in the study of Khadr et al, secondary OCI was found in about 25% of cases treated with SOF/DCV 24. But, this study was criticized by the small sample size (40 patients).…”

Section: Discussionmentioning

confidence: 85%

<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: Discussionmentioning

confidence: 85%

<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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“…The Pakistani study done by Idrees and colleagues (29) stated that chances of OCI increased in male patients and age above 30 years. Occult hepatitis C was found to be more predominant in males in a number of other studies (27,30) . Additionally, in a study by Habeeb et al (31) , male sex was a predictor of OCI in patients with anti-HCV antibodies.…”

Section: Discussionmentioning

confidence: 76%

“…Similar studies reported a considerably higher prevalence of OCI in sustained responders to DAAs who received SOF 400 mg and DAC 60 mg with and without weight-based RBV daily for 12 weeks. By testing HCV PCR in PBMCs, OCI rates of 22.7% (49 out of 215 patients) and 25% (10 out of 40 patients) were reported by Abd Alla et al (26) and Abu Khadr et al (27) respectively.…”

Section: Discussionmentioning

confidence: 83%

“…Another study found that there were statistically significant differences between the positive and negative patients with OCI regarding direct bilirubin but not indirect bilirubin (27) . This higher level of bilirubin and hepatic transaminases in OCI patients can be explained by the presence of a degree of microinflammation in the infected hepatocytes as was evident by research (18) .…”

Section: Discussionmentioning

confidence: 96%

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Age and Gender are Predictors for Occult Hepatitis C in Egyptian Sustained Responders to Directly Acting Antivirals

Yosef¹,

Hussein²,

Elzohary³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Background: Occult HCV infection (OCI) describes detectable viral RNA in the hepatocytes and in peripheral blood mononuclear cells (PBMCs) in the absence of conventional markers for HCV. The present study aimed to detect the prevalence of occult hepatitis C virus infection in patients who achieved a sustained virologic response (SVR) to directacting antiviral agents (DAAs) and to outline predictors of OCI. Patients and methods: This multicenter cross-sectional study included 50 males and 50 females seeking treatment for chronic hepatitis C patients without liver cirrhosis who were treated with combination of sofosbuvir (SOF) and daclatasvir (DCV) with or without ribavirin for three months and achieved SVR as proved by negative PCR after 12 weeks of the end of treatment. Twelve weeks after the end of treatment, HCV RNA was tested in PBMCs to detect OCI in patients with SVR. Logistic regression was used to find out factors affecting the presence of OCI. ROC curve was used to evaluate the performance of different tests to predict OCI. Results: Of the 100 patients, 12 (12%) had detectable HCV RNA in PBMCs after achieving SVR12 denoting presence of occult HCV infection. Age ≤45 years and male gender were significant predictors for occurrence of OCI. However, direct bilirubin ≥0.40 mg/dL was a significant predictor with low diagnostic performance. Conclusion: OCI can persist in sustained responders to DAA therapy and the risk of OCI is more prevalent in males younger than 45 years. Age and direct bilirubin can be possible predictors for OCI.

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“…Moreover, Khadr et al, found secondary OCI in about 25% of cases treated with SOF/DCV. However, this study was criticized for the small sample size (40 patients) (Abu Khadr et al, 2018). Abd Alla et al reported a high prevalence of OCI in treatment-experienced and naive cases (49 out of 215 non-viremia patients (22.7%)) (Abd Alla et al, 2017).…”

Section: Discussionmentioning

confidence: 98%

Detection of Occult Hepatitis C Virus Infection in Egyptian Patients Who Achieved a Sustained Virologic Response to Direct-Acting Antiviral Agents

Mashaal

El‐Hameed

Ray

et al. 2022

Asian Pac J Cancer Prev

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Background: Occult hepatitis C virus (HCV) infection (OCI) is diagnosed based on the detection of HCV-RNA in non-serum reservoirs, such as peripheral blood mononuclear cells (PBMCs) and/or hepatocytes with undetectable HCV-RNA in the serum. The current study was designed to shed more light on the presence of occult HCV in a population of cases who achieved an SVR after receiving treatments for HCV-infection and its significance. Methods: This cross-sectional study evaluated 111 chronic HCV patients treated at Theodor Bilharz Research Institute, Egypt and achieved a sustained virological response (SVR) 12 -24 weeks after treatment with Direct acting antiviral drugs (DAAs). The treatment lasted 12 or 24 weeks using generic medications including Sofosbuvir (SOF) 400 mg/day and Daclatasvir (DCV) 60 mg/day ± weight-based Ribavirin (RBV) 600-1000 mg/day. After achieving the SVR 12 -24 weeks, all patients were subjected to clinical examination and full laboratory investigations. All the candidates were assessed for fibrosis pre/post-treatment by transient elastography (Fibroscan©). Eighty-seven patients (78.4%) received dual therapy (SOF/DCV) and 24 patients (21.6%) received triple therapy (SOF/DCV/RBV). One hundred and seven patients received the regimen for 12 weeks (96.4%) and only four patients received the regimen for 24 weeks (3.6%). All patients were examined in terms of HCV RNA in plasma and PBMCs. Results: Nine patients (8.1%) were positive for PBMCs HCV RNA. The presence of Occult HCV infection (OCI) was significantly correlated with age, level of AFP, and the degree of liver stiffness. Conclusion: The OCI was present in 8.1% of the patients who achieved an SVR 12 -24 weeks. These patients were mostly aged and with elevated AFP and advanced fibrosis. Monitoring and follow-up of those patients may help to assess the outcomes.

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Secondary Occult Hepatitis C Virus Infection (HCV) in Chronic HCV Patients after Treatment with Sofosbuvir and Daclatasvir

Cited by 5 publications

References 22 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>

Age and Gender are Predictors for Occult Hepatitis C in Egyptian Sustained Responders to Directly Acting Antivirals

Detection of Occult Hepatitis C Virus Infection in Egyptian Patients Who Achieved a Sustained Virologic Response to Direct-Acting Antiviral Agents

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