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
Mohamed Said Abdel Aziz, Zienab Mostafa Saad, Wael Mohamed Abdel Ghani, Rofida Khalifa Moftah
Background and Aim of the work: The hepatitis C virus (HCV), an enveloped single-stranded RNA virus, was identified in 1989 and it was classified within the Flaviviridae family as a separate genus (Hepacivirus) The virus replicates by the synthesis of the complementary RNA strand (the so-called negative or antigenomic strand. So far, six major genotypes (HCV-1 to HCV-6) have been described, each containing multiple subtypes. We aim to detect occult HCV infection in post liver transplanted patients who received DAAs & achieve SVR12 ,to detect prevalence of this type of infection and its effect on graft dysfunction , fibrosis progression of he graft. Patients and Methods: This study was conducted 20 participants who had undergone LDLT for HCV related liver disease, recieved DAAs, achieved & maintained a sustained virologic response 12 weeks after therapy (SVR12) from a peroid of not less than 6 months. They recruited during the period from December 2016 to November 2017, from the Liver Transplantation unit, Faculty of Medicine, Cairo University. Results: This study is a cross-sectional prospective case control hospital based study that was done in the liver transplantation unit, El-Manial Specialized hospital, Faculty of Medicine, Cairo University from December 2016 to November 2017. A total 20 patients who had undergone Living donor liver transplantation for HCV related liver disease and they were eligible for HCV treatment and achieved SVR 12;, were included in the study. Conclusion: Detection of viral RNA in the peripheral blood mononuclear cells (PBMC) in patients with sustained virologic response following sofosbuvir-based direct acting antiviral treatments revealed detection of HCV RNA in 2 from a total of 20 patients included in our study (10%). Our study has found that occult hepatitis C virus infection is still a significant problem even after the era of direct antiviral agents; We detected the HCV RNA in the Peripheral blood mononuclear cells in 2 out of 20 (10%) among post liver transplanted patiens who maintained a sustained virologic response 12 weeks after therapy (SVR12) with direct-acting antiviral (DAA) agents.
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