Molecular Virology and Hepatology Research Group, Division of BioMedical Sciences, Faculty of Medicine, Health Sciences Centre, Memorial University, St John's, Newfoundland and Labrador, Canada.
Liver Int. 2010 Apr;30(4):502-11. doi: 10.1111/j.1478-3231.2009.02193.x. Epub 2010 Jan 7.
Occult hepatitis C virus infection (OCI) is a recently identified entity of which the existence became evident when nucleic acid amplification assays of enhanced sensitivity were introduced for the detection of hepatitis C virus (HCV) genome and its replication. This form of HCV infection has been found to persist in the presence of antibodies against HCV and normal levels of liver enzymes for years after spontaneous or antiviral therapy-induced resolution of hepatitis C and, therefore, can be termed as secondary OCI. HCV RNA in OCI circulate at fluctuating levels normally not exceeding 200 genome copies per millilitre of serum or plasma, while low levels of virus genome and its replicative intermediate RNA-negative strand are detectable in the liver and, importantly, immune cells, which provide an opportunity to detect active virus replication without the need for acquiring a liver biopsy. In addition to secondary OCI, a form of OCI accompanied by persistently moderately elevated serum liver enzymes in the absence of antibodies to HCV, which can be termed as cryptogenic OCI, has also been described. The current understanding of the nature and characteristics of OCI, methods and pitfalls of its detection, as well as the documented and expected pathological consequences of OCI will be summarized in this review.
隐匿性丙型肝炎病毒感染（OCI）是一种新发现的疾病实体，当使用高灵敏度核酸扩增检测方法检测丙型肝炎病毒（HCV）基因组及其复制时，其存在变得明显。这种形式的 HCV 感染在自发或抗病毒治疗诱导丙型肝炎缓解后多年，即使存在抗 HCV 抗体和正常水平的肝酶，仍会持续存在，因此可以被称为继发性 OCI。OCI 中的 HCV RNA 通常以波动的水平循环，不超过每毫升血清或血浆 200 个基因组拷贝，而在肝脏中，特别是在免疫细胞中，可以检测到低水平的病毒基因组及其复制中间体 RNA 阴性链，这为在无需获取肝活检的情况下检测活跃的病毒复制提供了机会。除了继发性 OCI 之外，还描述了一种伴有持续性中度升高的血清肝酶而无抗 HCV 抗体的 OCI 形式，可称为隐匿性 OCI。本综述将总结对 OCI 的性质和特征、检测方法及其陷阱的理解，以及已记录和预期的 OCI 的病理后果。
