Muazzam Ambreen G, Qureshi Saleem, Mansoor Atika, Ali Lubna, Iqbal Musarrat, Siddiqi Saima, Khan Khalid M, Mazhar Kehkashan
Institute of Biomedical and Genetic Engineering, Islamabad, Pakistan.
Genet Vaccines Ther. 2011 Sep 6;9(1):14. doi: 10.1186/1479-0556-9-14.
A recently discovered occult HCV entity reported by various investigators seems to be highly controversial. Especially, the clinical significance of these findings remains uncertain. For optimal outcome of antiviral therapy, investigation of occult HCV needs a broad-based probe in order to investigate the results of viral therapy and its host/viral interaction. The current study was aimed at determining the prevalence of occult HCV in peripheral blood lymphocytes of predominantly genotype 3 HCV-infected patients after completion of antiviral therapy and to investigate long term outcomes in the presence or absence of PBMC positivity.
A total of 151 chronic, antiHCV and serum RNA-positive patients were enrolled in the study. Patients with a complete virological response at the end of treatment were screened for the presence of viral RNA in their PBMCs and were followed for up to one year for the presence of serum and PBMC viral genomic RNA.
Out of 151 patients, 104 (70%) responded to the prescribed interferon treatment and showed viral-clearance from serum. These were screened for the presence of genomic RNA in their PBMCs. Sixteen samples were PBMC-positive for viral RNA at the end of treatment (EOT). All these patients had also cleared the virus from peripheral blood cells after the 6-12 month follow-up study.
True occult hepatitis C virus does not exist in our cohort. Residual viremia at the EOT stage merely reflects a difference in viral kinetics in various compartments that remains a target of immune response even after the end of antiviral therapy and is eventually cleared out at the sustained viral response (SVR).
不同研究者报道的一种最近发现的隐匿性丙型肝炎病毒实体似乎极具争议性。尤其是，这些发现的临床意义仍不明确。为了使抗病毒治疗取得最佳效果，对隐匿性丙型肝炎病毒的研究需要进行广泛的探索，以便研究病毒治疗的结果及其宿主/病毒相互作用。本研究旨在确定主要感染基因型3丙型肝炎病毒的患者在抗病毒治疗完成后外周血淋巴细胞中隐匿性丙型肝炎病毒的患病率，并研究外周血单个核细胞（PBMC）阳性或阴性情况下的长期结果。
共有151例慢性、抗丙型肝炎病毒且血清RNA阳性的患者纳入本研究。对治疗结束时获得完全病毒学应答的患者进行PBMC中病毒RNA的筛查，并随访长达一年，观察血清和PBMC中病毒基因组RNA的情况。
151例患者中，104例（70%）对规定的干扰素治疗有应答，血清病毒清除。对这些患者进行PBMC中基因组RNA的筛查。治疗结束时，16个样本的PBMC病毒RNA呈阳性。在6 - 12个月的随访研究后，所有这些患者的外周血细胞中也清除了病毒。
我们的队列中不存在真正的隐匿性丙型肝炎病毒。治疗结束时的残留病毒血症仅仅反映了不同区室中病毒动力学的差异，即使在抗病毒治疗结束后，这仍是免疫反应的靶点，并最终在持续病毒学应答（SVR）时被清除。
