Prevalence of Occult HCV Infections in Saudi Patients who Achieved Sustained Virologic Response with Direct Acting Antiviral Treatment

Abstract

Background: Occult hepatitis C virus (HCV) infection (OCI) is a condition where HCV RNA is present in hepatocytes or peripheral blood mononuclear cells (PBMCs), but not in the serum, in patients treated for hepatitis C infection. Serum HCV antibodies may or may not be present. Aim: We investigated the prevalence of OCI in PBMCs and hepatocytes in patients who had achieved sustained virologic response (SVR) after 24 weeks of direct-acting antiviral treatment.Methods: Chronic HCV patients with Genotype 1a and 4 who achieved SVR 24 weeks after treatment with direct-acting antiviral agents (DAAs) were prospectively selected. RNeasy Blood and Tissue Kit (Qiagen GmbH, Germany) was used for RNA extraction from blood and liver tissue samples. Superscript IV First-Strand Synthesis System (Invitrogen) was used for reverse transcription PCR. Quantitative and qualitative detection of HCV RNA was performed using primers specific to the 5′ untranslated region (5′ UTR).Patients: Of the six chronic HCV patients recruited for this study, five were infected with genotype 4 and one with genotype 1a. Five patients were treated with Sofosbuvir and Daclatasvir, and one patient with Ledipasvir plus Sofosbuvir.Results: None of the patients had detectable HCV RNA in either the PBMCs or hepatocytes, suggesting zero prevalence of OCI in patients who achieved 24 weeks SVR post DAA treatment. Conclusion: We failed to detect HCV RNA in both the hepatocytes and PBMCs of all patients recruited for the study. This finding suggests that OCI is a rare phenomenon and uncommon among immunocompetent patients.