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Occult hepatitis C virus infection: what does it mean?
Tram N Q Pham1, Carla S Coffin, Tomasz I Michalak
1Molecular Virology and Hepatology Research Group, Division of BioMedical Sciences, Faculty of Medicine, Health Sciences Centre, Memorial University, St John's, Newfoundland and Labrador, Canada.
Summary
Occult hepatitis C virus infection (OCI) persists despite resolved symptoms and normal liver enzymes. Detecting HCV RNA in immune cells offers a non-invasive diagnostic approach for this persistent infection.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Occult hepatitis C virus infection (OCI) is a recently identified clinical entity.
- OCI is characterized by the persistence of hepatitis C virus (HCV) despite the absence of detectable antibodies or normal liver enzymes.
Purpose of the Study:
- To review the current understanding of OCI's nature and characteristics.
- To discuss detection methods, pitfalls, and pathological consequences of OCI.
Main Methods:
- Detection of HCV genome and replication using sensitive nucleic acid amplification assays.
- Analysis of HCV RNA levels in serum/plasma and detection in liver and immune cells.
- Distinguishing between secondary OCI and cryptogenic OCI.
Main Results:
- HCV RNA in OCI typically circulates at low levels (<200 copies/mL).
- Active viral replication can be detected in the liver and immune cells, potentially avoiding liver biopsy.
- Two forms of OCI are described: secondary OCI and cryptogenic OCI.
Conclusions:
- OCI represents a persistent form of HCV infection with unique diagnostic challenges.
- Detection in immune cells offers a promising non-invasive diagnostic strategy.
- Understanding OCI is crucial for managing long-term HCV-related pathology.
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