Occult HCV Infection (OCI) Diagnosis in Cirrhotic and Non-cirrhotic Naïve Patients by Intra-PBMC Nested Viral RNA PCR.

Occult HCV infections (OCIs) include IgG antibody seronegative cryptogenic (COCIs), as well as seropositive secondary naïve (SNOCIs) and experienced (SEOCIs) cases. We used peripheral-blood-mononuclear-cell (PBMC)-PCR to evaluate COCIs and SNOCIs prevalence, serum HCV spontaneous disappearance (SCSD) in naïve cirrhotics and non-cirrhotics, intra-PBMC HCV-RNA strands in relation to cirrhosis density in naïve non-viremia cases, and HCV-RNA seroconversion after 1 year of solitary naïve intra-PBMC infection. The anti-HCV IgG antibody-positive naïve-patients ( = 785) were classified into viremic ( = 673) and non-viremic [ = 112, including non-cirrhotics ( = 55) and cirrhotics ( = 57)], and 62 controls without evidence of HCV-infection. Controls and post-HCV non-viremia cases ( = 62+112 = 174) were submitted to hepatic Fibroscan-Elastography evaluation. All subjects ( = 847) were screened for intra-PBMC HCV-RNA sense and antisense strands by nested-PCR. Naïve-OCI cases (4.84%) that were diagnosed by PBMC-PCR significantly raised the total numbers of HCV-infection to 714 ( = 0.01). The percent positivity of SNOCIs (34.82%) was significantly higher than for asymptomatic-COCIs (3.125%, = 0.0001). Comparing PBMC-PCR with single-step-reverse-transcription (SRT)-PCR for identification of SCSD in naïve IgG antibody-positive non-viremia patients ( = 112) revealed a decline in SCSD prevalence by PBMC-PCR (from 14.27% to 9.3%), regardless of presence of hepatic cirrhosis ( = 0.03). SCSD was found to be higher by PBMC-PCR in non-cirrhotics compared to cirrhotics ( = 0.0001), with an insignificant difference when using SRT-PCR ( = 0.45). Intra-PBMC HCV-RNA infection was significantly more frequent in cirrhotics compared to both non-cirrhotics and controls ( < 0.0005). An increased hepatic fibrosis density was recognized in intra-PBMC HCV-RNA infection with sense ( = 0.0001) or antisense strand ( = 0.003). HCV-RNA seroconversion was associated with intra-PBMC infection when both sense and antisense strands were detected ( = 0.047). Intracellular HCV-RNA evaluation is crucial for diagnosing OCIs and addressing relapse probability.