ABSTRACT
Introduction and aim: chronic hepatitis C infection [CHC] is a global health-care problem with an increasing burden year-by-year, particularly in Egypt. Even with the advent of high sensitive techniques, a subset of patients with positive HCV-Ab and negative HCV-viremia remain challenging. Therefore, we herein tried to determine the prevalence of occult HCV infection in peripherd blood mononuclear cells [PBMCs] of Patients presented with positive serologic test for anti-HCV-Ab and negative serum HCV-RNA-PCR [spontaneously cleared-patients] and also, we followed up those patients
Patients and Methods: between March 2010 to March 2015, a prospective study was designed to include all consecutive patients with HCV-Ab positivity and HCV-RNA negativity who attended to Assiut unit for treatment of viral hepatitis; sector of national committee for contrbl of viral hepatitis. A total of 25 patients were recruited. Spontaneous clearance of serum HCV infection was approved by [HCV-Ab positive using two 3rd generation ELISA tests and serum HCV RNA negative in three consecutive occasion each six months apart]. Follow up serum HCV RNA for patients with Occult 1 HCV Infection every 6 months. The RNA extraction step was performed by a protocol modified from, that of the QIAamp viral RNA kits [Qiagen, courtaboeuf, France]. Blood samples for separation of I PBMCs were collected from all patients. PBMCs were obtained using Ficoll-Hypaque density gradient of EDTA anticoagulated blood according to the manufacturer's instructions [Lymphoflot, Biotest,Dreleich, Germany]. Detection of HCV viral load was performed by kit supplied by applied Biosystem [HCV RT-PCR Kit lot No.]
Results: a total of 25 [21 males, mean age 36.2 +/- 9.1] patients who cleared HCV spontaneously [HCV- Ab positive and serum HCV RNA negative]. The genomic HCV RNA was detected in PBMCs from 3 [12%] of 25 patients. Follow up for those three patients with occult HCV infection were done for 18 months by measuring serum HCV RNA by using highly sensitive real-time Polymerase Chain Reaction [RT-PCR] every 6 months, only single patient became overt HCV with low level of viremia
Conclusion: occult HCV infection was detected in a considerable prevalence in patients in whom apparent clearance of HCV-viral load occurred that entails corporations of HCV-viral assay in PBMCs into the diagnostic algorithm