Prevalence of Occult HCV Infections in Saudi Patients who Achieved Sustained Virologic Response with Direct Acting Antiviral Treatment

Al Ashgar, Hamad; AlQahtani, Ahmed; Al Quaiz, Consultant, Gastroenterologist Mohammed; Alhussaini, Hussa; Al Kahtani, Khalid; Elssadany, Amr 	M; Alqahtani, Saleh 	A; PEEDIKAYIL, MUSTHAFA C

doi:10.21608/mjvh.2021.33028.1003

Prevalence of Occult HCV Infections in Saudi Patients who Achieved Sustained Virologic Response with Direct Acting Antiviral Treatment

Articles in Press

Document Type : Original article

Authors

Hamad Al Ashgar ¹
Ahmed AlQahtani ²
Consultant, Gastroenterologist Mohammed Al Quaiz ³
Hussa Alhussaini ⁴
Khalid Al Kahtani ³
Amr M Elssadany ⁵
Saleh A Alqahtani ⁶
MUSTHAFA C PEEDIKAYIL ⁷

¹ Consultant, Gastroenterologist.King Faisal Specialist Hospital and Research Centre. Riyadh. Saudi Arabia. Pin 11211

² Consultant, Department of Infection and Immunity,King Faisal Specialist Hospital and Research Centre. Riyadh. Saudi Arabia. Pin 11211

³ Consultant, Gastroenterologist, King Faisal Specialist Hospital and Research Centre. Riyadh. Saudi Arabia. Pin 11211

⁴ Consultant, Anatomic pathology,King Faisal Specialist Hospital and Research Centre. Riyadh. Saudi Arabia. Pin 11211

⁵ Associate consultant, Radiology, King Faisal Specialist Hospital and Research Centre. Riyadh. Saudi Arabia. Pin 11211

⁶ Consultant hepatologist, King Faisal Specialist Hospital and Research Centre. Riyadh. Saudi Arabia. Pin 11211

⁷ KING FAISAL SPECIALIST HOSPITAL AND RESEARCH CENTER,PO BOX NO.3354

10.21608/mjvh.2021.33028.1003

Abstract

Background: Occult hepatitis C virus (HCV) infection (OCI) is a condition where HCV RNA is present in hepatocytes or peripheral blood mononuclear cells (PBMCs), but not in the serum, in patients treated for hepatitis C infection. Serum HCV antibodies may or may not be present.
Aim: We investigated the prevalence of OCI in PBMCs and hepatocytes in patients who had achieved sustained virologic response (SVR) after 24 weeks of direct-acting antiviral treatment.
Methods: Chronic HCV patients with Genotype 1a and 4 who achieved SVR 24 weeks after treatment with direct-acting antiviral agents (DAAs) were prospectively selected. RNeasy Blood and Tissue Kit (Qiagen GmbH, Germany) was used for RNA extraction from blood and liver tissue samples. Superscript IV First-Strand Synthesis System (Invitrogen) was used for reverse transcription PCR. Quantitative and qualitative detection of HCV RNA was performed using primers specific to the 5′ untranslated region (5′ UTR).
Patients: Of the six chronic HCV patients recruited for this study, five were infected with genotype 4 and one with genotype 1a. Five patients were treated with Sofosbuvir and Daclatasvir, and one patient with Ledipasvir plus Sofosbuvir.
Results: None of the patients had detectable HCV RNA in either the PBMCs or hepatocytes, suggesting zero prevalence of OCI in patients who achieved 24 weeks SVR post DAA treatment.
Conclusion: We failed to detect HCV RNA in both the hepatocytes and PBMCs of all patients recruited for the study. This finding suggests that OCI is a rare phenomenon and uncommon among immunocompetent patients.

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