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Diseases of the Liver and Gallbladder01:26

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Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
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Hepatitis is an inflammatory condition of the liver most commonly caused by hepatotropic viruses (A–E), though non-infectious causes such as alcohol and drugs also exist.Hepatitis AHepatitis A virus (HAV) is a non-enveloped RNA virus of the Picornaviridae family. It is primarily transmitted via the fecal-oral route, typically through ingestion of contaminated food or water. After ingestion, HAV enters the bloodstream through the oropharynx or intestinal epithelium and reaches the liver.
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Viral Hepatitis I: Introduction01:28

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Viral hepatitis is an inflammatory condition of the liver caused by infection with hepatotropic viruses, most commonly hepatitis A, B, C, D, and E. Despite variations in structure and transmission, all viruses mentioned infect hepatocytes and provoke immune responses that can hinder liver function. Additionally, some non-hepatotropic viruses can also lead to hepatic inflammation.Hepatitis A VirusHepatitis A virus (HAV) is transmitted through the fecal–oral route, typically by ingestion...
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Cirrhosis is a chronic, irreversible liver disease characterized by the widespread replacement of healthy liver tissue with fibrotic scar tissue and the formation of regenerative nodules.Etiology of cirrhosisCirrhosis results from sustained liver injury that triggers progressive fibrosis and structural remodeling. The underlying causes are diverse, encompassing common and less frequent clinical conditions. Regardless of the origin, all causes lead to chronic inflammation, hepatocyte loss, and...
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Cirrhosis II: Pathophysiology01:24

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Cirrhosis is a progressive chronic liver injury caused by prolonged inflammation, excessive fibrotic remodeling, and impaired regeneration. Over time, repeated hepatic insults disrupt the liver’s architecture and function, leading to reduced blood flow, impaired bile drainage, and diminished metabolic capacity.Pathophysiology of cirrhosisCirrhosis arises from three main responses to chronic liver damage: inflammation, immune activation, and hepatocyte death. These processes lead to...
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Chronic pancreatitis is a progressive and irreversible inflammation of the pancreas, most often caused by long-term alcohol abuse, but it can also be related to ductal obstruction, smoking, or genetic factors.Chronic pancreatitis occurs when the pancreas is repeatedly exposed to harmful agents like alcohol, smoking, ductal obstruction, or genetic predisposition. These factors lead to the release of toxic metabolites and inflammatory cytokines, sustaining chronic inflammation in the pancreatic...
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Occult Hepatitis C Virus Infection: A Narrative Review.

Busara Songtanin1,2, Jackeline Flores2, Romelia Barba2

  • 1Division of Gastroenterology, Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.

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|July 5, 2025
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Summary

Occult hepatitis C virus (HCV) infections are hard to detect, with the virus present in liver cells and PBMCs but not serum. Further research is needed for better diagnosis and treatment of this challenging HCV variant.

Keywords:
hepatitishepatitis C virusoccult hepatitis C infectionperipheral blood mononuclear cells

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Area of Science:

  • Hepatology
  • Virology
  • Immunology

Background:

  • Hepatitis C virus (HCV) infections are globally prevalent, with a significant proportion progressing to chronic disease.
  • Occult hepatitis C is characterized by HCV RNA in hepatocytes and PBMCs, but not serum, often with negative anti-HCV antibodies, complicating detection.
  • These infections are more common in individuals with co-infections (Hepatitis B, HIV), liver disease, renal failure, and lymphoproliferative disorders.

Purpose of the Study:

  • To highlight the diagnostic challenges posed by occult hepatitis C infections.
  • To discuss the potential role of occult HCV in liver disease progression and treatment relapse.
  • To emphasize the need for improved diagnostic and therapeutic strategies for occult HCV.

Main Methods:

  • Review of existing literature on occult hepatitis C.
  • Analysis of viral presence in hepatocytes and peripheral blood mononuclear cells (PBMCs).
  • Discussion of diagnostic difficulties, including limitations of standard serological tests and the need for specialized assays.

Main Results:

  • Occult HCV infections are characterized by detectable HCV RNA in liver cells and PBMCs, but not in serum.
  • These infections are associated with ongoing liver damage and potential transmission to adjacent cells and extrahepatic sites.
  • Occult HCV may contribute to cryptogenic liver disease, steatosis, cirrhosis, hepatocellular carcinoma, and treatment/spontaneous clearance relapses.

Conclusions:

  • Occult hepatitis C presents significant diagnostic challenges, often requiring liver biopsy or specialized PBMC analysis.
  • The development of viral quasispecies in PBMCs may explain treatment failures and ineffective host responses.
  • Further research is crucial to refine diagnostic algorithms, understand the role in liver disease pathogenesis, and establish effective treatment protocols for occult HCV infections.