Detection of Occult Hepatitis C Virus Infection in Patients Who Achieved a Sustained Virologic Response to Direct-Acting Antiviral Agents for Recurrent Infection After Liver Transplantation
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Summary
This summary is machine-generated.Occult hepatitis C virus (HCV) infection may persist after direct-acting antiviral therapy in liver transplant patients. Some patients achieving sustained virologic response still show signs of active, hidden HCV infection.
Area Of Science
- Hepatology
- Virology
- Transplantation Immunology
Background
- Occult hepatitis C virus (HCV) infection is defined by HCV genome presence in tissues, not serum, despite undetectable serum HCV RNA.
- Recurrent HCV infection post-liver transplantation poses a significant clinical challenge.
- Direct-acting antiviral (DAA) agents have revolutionized HCV treatment, achieving high sustained virologic response (SVR) rates.
Purpose Of The Study
- To investigate the presence of occult HCV infection in liver transplant recipients who achieved SVR12 after DAA therapy.
- To assess viral replication in patients with abnormal aminotransferase levels despite achieving SVR12.
Main Methods
- Prospective study of 134 liver transplant patients with recurrent HCV treated with DAAs.
- Analysis of patients (n=14) with non-normalized or transiently normalized aminotransferase levels post-therapy.
- Detection of occult HCV infection using reverse transcription quantitative polymerase chain reaction (RT-qPCR) to identify negative-strand viral RNA.
Main Results
- 129 out of 134 patients achieved SVR12.
- In 14 patients ( >10%), aminotransferase levels remained abnormal or fluctuated post-DAA therapy.
- Among these 14 patients, 55% (n=5) exhibited occult HCV infection, evidenced by detectable negative-strand viral RNA, indicating ongoing viral replication.
Conclusions
- Occult HCV infection can persist in some liver transplant recipients despite achieving SVR12 with DAAs.
- Abnormal aminotransferase levels post-treatment may indicate the presence of occult HCV infection.
- Detection of negative-strand HCV RNA is crucial for identifying active occult infection in these patients.