Chang Ming-Ling, Chen Wei-Ting, Pao Li-Heng, Chiu Cheng-Hsun, Chien Rong-Nan
Division of Hepatology, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Microbiol Spectr. 2025 Aug 5;13(8):e0292224. doi: 10.1128/spectrum.02922-24. Epub 2025 Jun 24.
The phenotype of occult hepatitis C virus (HCV) infection (OCI) in anti-HCV treatment-naive patients remains elusive. A prospective 3-year cohort study of 218 anti-HCV treatment-naive patients was conducted. OCI was defined as positive HCV RNA in peripheral blood mononuclear cells (PBMCs) of patients with negative serum HCV RNA. Among the 128 HCV antibody (Ab)-positive patients, 15 (11.7%) had OCI; higher HCV Ab titers were noted in patients with OCI than in those without OCI (84.25 ± 64.76 vs 46.60 ± 46.07 ng/mL, = 0.006), and the HCV Ab titer was a marker of OCI (cutoff: >53.2 ng/mL). The 3-year cumulative incidence (CI) of cardiovascular events was greater in patients with OCI than in those without OCI (84% vs 46.4%, = 0.043). Among the 90 HCV Ab-negative patients, 5 (5.6%) had OCI; the alanine aminotransferase (ALT) levels were greater in patients with OCI than in those without OCI (114.4 ± 71.6 vs 67.2 ± 87.4 U/L, = 0.035). A greater CI of autoimmune disease was noted in patients with OCI than in those without OCI (20% vs 1.2%, = 0.006). Among anti-HCV treatment-naive patients, the prevalence rates of OCI were 11.7% in HCV Ab-positive patients and 5.6% in HCV Ab-negative patients. High HCV Ab titers in HCV Ab-positive patients require caution regarding OCI and cardiovascular events, and cryptogenic hepatitis warrants suspicion of OCI and autoimmune diseases.IMPORTANCEAmong anti-HCV treatment-naive patients, the prevalence rates of OCI were 11.7% in HCV Ab-positive patients and 5.6% in HCV Ab-negative patients. High HCV Ab titers (cutoff: >53.2 ng/mL) in HCV Ab-positive patients require caution regarding OCI and cardiovascular events, and cryptogenic hepatitis warrants suspicion of OCI and autoimmune diseases.
在未经抗丙型肝炎病毒（HCV）治疗的患者中，隐匿性丙型肝炎病毒（HCV）感染（OCI）的表型仍不明确。对218例未经抗HCV治疗的患者进行了一项为期3年的前瞻性队列研究。OCI被定义为血清HCV RNA阴性患者外周血单个核细胞（PBMC）中HCV RNA阳性。在128例HCV抗体（Ab）阳性患者中，15例（11.7%）存在OCI；OCI患者的HCV Ab滴度高于无OCI患者（84.25±64.76 vs 46.60±46.07 ng/mL，P = 0.006），且HCV Ab滴度是OCI的一个标志物（临界值：>53.2 ng/mL）。OCI患者心血管事件的3年累积发病率高于无OCI患者（84% vs 46.4%，P = 0.043）。在90例HCV Ab阴性患者中，5例（5.6%）存在OCI；OCI患者的丙氨酸氨基转移酶（ALT）水平高于无OCI患者（114.4±71.6 vs 67.2±87.4 U/L，P = 0.035）。OCI患者自身免疫性疾病的累积发病率高于无OCI患者（20% vs 1.2%，P = 0.006）。在未经抗HCV治疗的患者中，HCV Ab阳性患者的OCI患病率为11.7%，HCV Ab阴性患者为5.6%。HCV Ab阳性患者中高HCV Ab滴度（临界值：>53.2 ng/mL）需要警惕OCI和心血管事件，不明原因肝炎应怀疑OCI和自身免疫性疾病。重要性在未经抗HCV治疗的患者中，HCV Ab阳性患者的OCI患病率为
