DIRECT ACTING ANTIVIRAL THERAPY AND OCCULT HEPATITIS C IN UPPER EGYPT: RECENT ADVANCES IN HEPATITIS C VIRUS MANAGEMENT

Abstract

Background: depending on current estimates, the prevalence of the hepatitis C virus (HCV), one of the leading causes of death and illness worldwide, has increased over the past ten years to 2.8%, or more than 185 million infections globally. Although there is no vaccination, the infection can be healed with short-term, eight to twelve weeks therapies by direct acing antiviral drugs (DAAs) that are very successful and curative. Occult HCV infection (OCI) is described by HCV RNA being present in peripheral blood mononuclear cells or hepatocytes but remains undetected in serum.

Objectives: To detect occurrence of OCI in upper Egypt among chronic HCV cases in who achieved sustained virologic response (SVR) following management with DAA by 24 weeks later.

Methods: the study contains 301 HCV cases who achieved SVR following management with DAA (group1), and 100 healthy controls (group2) have been involved in this research. Routine laboratory investigations (complete blood count (CBC), kidney and liver function tests and alpha-feto protein) and HCV RNA in serum and peripheral blood mononuclear cells were done for all participants in both groups.

Results: Despite achieving SVR after DAA treatment and maintaining undetectable serum HCV RNA, persistence of HCV RNA in PBMCs was identified in 3 out of 301 cases (1%).

Conclusion: Simultaneous measurement of HCV RNA in both serum and PBMCs at the end of management with DAAs and through validation of SVR is recommended. Further studies are required to find out the potential predictors for persistence of OCI after treatment.