Occult Hepatitis C Virus Infection in Patients in Whom the Etiology of Persistently Abnormal Results of Liver-Function Tests Is Unknown

• Published in: The Journal of infectious diseases Vol. 189; no. 1; pp. 7 - 14
• Main Authors: Castillo, Inmaculada, Pardo, Margarita, Bartolomé, Javier, Ortiz-Movilla, Nuria, Rodríguez-lñigo, Elena, de Lucas, Susana, Salas, Clara, Jiménez-Heffernan, Jose A., Pérez-Mota, Arturo, Graus, Javier, López-Alcorocho, Juan Manuel, Carreño, Vicente
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.01.2004; University of Chicago Press; Oxford University Press
• Subjects: Adult; Aged; Alanine Transaminase - blood; Antibodies; Biological and medical sciences; Biopsy; Chronic hepatitis; Cohort Studies; Female; Fundamental and applied biological sciences. Psychology; gamma-Glutamyltransferase - blood; Genotype; Glutamyl Aminopeptidase - blood; Hepacivirus; Hepacivirus - genetics; Hepacivirus - isolation & purification; Hepacivirus - pathogenicity; Hepatitis C; Hepatitis C - blood; Hepatitis C - complications; Hepatitis C - diagnosis; Hepatitis C Antibodies - blood; Hepatitis C virus; Hepatocytes; Human viral diseases; Humans; In Situ Hybridization; Infections; Infectious diseases; Leukocytes, Mononuclear - virology; Liver; Liver - enzymology; Liver - virology; Liver Diseases - enzymology; Liver Diseases - etiology; Liver Function Tests; Male; Medical sciences; Microbiology; Middle Aged; Polymerase chain reaction; Reverse Transcriptase Polymerase Chain Reaction; RNA; RNA, Viral - analysis; RNA, Viral - blood; Viral diseases; Viral hepatitis; Viruses; Human; Infection; Microbiology; Viral disease; Digestive diseases; Hepatic disease; Viral hepatitis C
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/380202

BackgroundThere are patients in whom the etiology of long-standing abnormal results of liver-function tests is unknown (ALF-EU) after exclusion of all known causes of liver diseases. We analyzed the presence of hepatitis C virus (HCV) RNA in liver-biopsy specimens from 100 patients who were negative for anti-HCV antibodies and for serum HCV RNA and who had ALF-EU MethodsHCV RNA status was tested by reverse-transcription polymerase chain reaction (RT-PCR) and by in situ hybridization, in liver and peripheral-blood mononuclear cells (PBMCs) ResultsHCV RNA was detected in liver-biopsy specimens from 57 of 100 patients negative for anti-HCV antibodies and for serum HCV RNA (i.e., who had occult HCV infection). HCV RNA of negative polarity was found in the liver of 48 (84.2%) of these 57 patients with occult HCV infection. Nucleotide-sequence analysis confirmed the specificity of detection of HCV RNA and that patients were infected with the HCV 1b genotype. Of these 57 patients with intrahepatic HCV RNA, 40 (70%) had viral RNA in their PBMCs. With regard to liver histology, patients with occult HCV infection were more likely to have necroinflammatory activity (P=.017) and fibrosis (P=.022) than were patients without intrahepatic HCV RNA ConclusionPatients with ALF-EU may have intrahepatic HCV RNA in the absence of anti-HCV antibodies and of serum HCV RNA