Fundación para el Estudio de las Hepatitis Virales, Madrid, Spain.
Liver Int. 2011 Nov;31(10):1519-24. doi: 10.1111/j.1478-3231.2011.02613.x. Epub 2011 Aug 9.
Patients with occult hepatitis C virus (HCV) infection (HCV-RNA in liver without detectable anti-HCV and serum HCV-RNA) may have viral RNA in peripheral blood mononuclear cells (PBMCs) and in serum after ultracentrifugation, and may present HCV-specific T-cell responses, but it is unknown whether these markers persist to be detectable over time.
To perform a prospective virological long-term follow up of patients with occult HCV.
Viral markers were tested every 3-4 months during 55.7 ± 20.3 months in 37 patients with occult HCV who were under ursodeoxycholic acid treatment.
Viral RNA was detectable in PBMCs of 31 patients during the follow up. In 23 of them, viral RNA in PBMCs was detected intermittently and in the other eight patients HCV-RNA was positive in a single sample. After ultracentrifugation, serum HCV-RNA was detected in 33 patients, being the viraemia intermittently detectable in 28, whereas in the remaining five patients, serum HCV-RNA was positive only once. Only one patient tested always HCV-RNA negative in PBMCs and in ultracentrifuged serum during follow up. Specific Core, NS3, and/or NS4 T-cell responses were found in 31 of the patients. The patient who was always HCV-RNA negative in PBMCs and in ultracentrifuged serum had specific HCV-T-cell responses.
Occult HCV infection persists over time with fluctuating viraemia levels that induce and maintain specific T-cell responses against viral proteins.
隐匿性丙型肝炎病毒（HCV）感染（肝内存在 HCV-RNA，但无法检测到抗-HCV 和血清 HCV-RNA）的患者外周血单个核细胞（PBMC）和超速离心后的血清中可能存在病毒 RNA，且可能存在 HCV 特异性 T 细胞应答，但这些标志物是否会持续存在并随时间推移而被检测到尚不清楚。
对隐匿性 HCV 患者进行前瞻性病毒学长期随访。
37 例隐匿性 HCV 患者在熊去氧胆酸治疗下进行了 55.7±20.3 个月的随访，每 3-4 个月检测一次病毒标志物。
31 例患者在随访期间 PBMC 中可检测到病毒 RNA。其中 23 例患者的 PBMC 中 HCV-RNA 间歇性检出，另外 8 例患者单次样本中 HCV-RNA 阳性。经超速离心后，33 例患者血清中可检测到 HCV-RNA，28 例患者间歇性检出病毒血症，而另外 5 例患者仅在单次样本中呈阳性。在随访期间，只有 1 例患者的 PBMC 和超速离心血清中 HCV-RNA 始终为阴性。31 例患者中均发现了核心、NS3 和/或 NS4 特异性 T 细胞应答。在 PBMC 和超速离心血清中始终 HCV-RNA 阴性的患者存在针对 HCV 蛋白的特异性 T 细胞应答。
隐匿性 HCV 感染随时间推移持续存在，病毒血症水平波动，诱导并维持针对病毒蛋白的特异性 T 细胞应答。
