New perspectives in occult hepatitis C virus infection

• Published in: World journal of gastroenterology : WJG Vol. 18; no. 23; pp. 2887 - 2894
• Main Author: Vicente Carreno Javier Bartolome Inmaculada Castillo Juan Antonio Quiroga
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Co., Limited 21.06.2012
• Subjects: Antiviral Agents - therapeutic use; Asymptomatic Infections; Hepacivirus - genetics; Hepatitis C - diagnosis; Hepatitis C - drug therapy; Hepatitis C - immunology; Humans; Leukocytes, Mononuclear - chemistry; Liver - chemistry; RNA, Viral - analysis; Serologic Tests; T细胞反应; 丙型肝炎病毒; 外周血单个核细胞; 抗原特异性; 抗病毒治疗; 病毒感染; 肝脏疾病; 隐匿性; Peripheral blood mononuclear cells; Hepatitis C virus RNA; Occult hepatitis C virus; Liver; T-cell response
• ISSN: 1007-9327; 2219-2840; 2219-2840
• DOI: 10.3748/wjg.v18.i23.2887

Occult hepatitis C virus （HCV） infection, defined as the presence of HCV RNA in liver and in peripheral blood mononuclear cells （PBMCs） in the absence of detectable viral RNA in serum by standard assays, can be found in anti-HCV positive patients with normal serum levels of liver enzymes and in anti-HCV negative patients with persistently elevated liver enzymes of unknown etiology. Occult HCV infection is distributed worldwide and all HCV genotypes seem to be involved in this infection. Occult hepatitis C has been found not only in anti-HCV positive subjects with normal values of liver enzymes or in chronic hepatitis of unknown origin but also in several groups at risk for HCV infection such as hemodialysis patients or family members of patients with occult HCV. This occult infection has been reported also in healthy populations without evidence of liver disease. Occult HCV infection seems to be less aggressive than chronic hepatitis C although patients affected by occult HCV may develop liver cirrhosis and even hepatocellular carcinoma. Thus, anti-HCV negative patients with occult HCV may benefit from antiviral therapy with pegylated-interferon plus ribavirin. The persistence of very low levels of HCV RNA in serum and in PBMCs, along with the maintenance of specific T-cell responses against HCV-antigens observed during a long-term follow-up of patients with occult hepatitis C, indicate that occult HCV is a persistent infection that is not spontaneously eradicated. This is an updated report on diagnosis, epidemiology and clinical implications of occult HCV with special emphasis on anti-HCV negative cases.