virus replication seen in patients with apparent viral clearance
2006-11-07 8:45:16 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Hepatitis C virus (HCV)
can persist and replicate in the livers of patients who have
apparently cleared the virus from their blood after antiviral
therapy, according to a report in the November 15th issue of
Clinical Infectious Diseases.
Previous studies have identified positive-strand HCV RNA in
the hepatic tissue of patients with a sustained treatment
response. However, it was unclear if viable HCV, capable of
replication, was actually present since negative-strand HCV RNA,
the viral replicative intermediate, was not detected.
In the present study, Dr. Vicente Carreno and colleagues,
from the Foundation for the Study of Viral Hepatitis in Madrid,
Spain, tested for positive- and negative-strand HCV RNA in
hepatic tissue taken from 20 patients who had shown no serologic
evidence of the virus for 35.4 months on average.
Nineteen of the 20 samples contained positive-strand HCV RNA,
the report indicates. Moreover, of these 19 samples, 15 had
negative-strand HCV RNA also.
Testing of peripheral blood mononuclear cells revealed
positive-strand HCV RNA in 13 of 20 samples. Twelve of the 13
samples also contained negative-strand HCV RNA.
The posttreatment liver biopsy specimens of 15 patients still
displayed liver necroinflammation, the findings indicate, and
fibrosis remained present in seven patients. However, hepatic
damage improved in all but two of the patients.
The findings indicate that "these patients did not experience
HCV infection clearance, despite apparent clinical disease
resolution," the researchers conclude.
They say the possibility of reactivation should be borne in
mind if patients undergo chemotherapy of become
immunosuppressed, for example. The team cites a case in which
HCV reemerged following prednisone therapy, after 8.5 years of
negative test results.