Detection of Occult Hepatitis C and Hepatitis B Virus Infections from Peripheral Blood Mononuclear Cells

Faculty of Medicine, Clinical Pathology, Gomhoria st, Mansoura, Egypt.
Immunological Investigations (Impact Factor: 1.99). 01/2010; 39(3):284-91. DOI: 10.3109/08820131003605820
Source: PubMed


To investigate the problem of occult HCV & HBV infections in patients with persistently longstanding abnormal liver function test results of unknown etiology and to investigate occult HCV in patients with sustained virological response (SVR).
The study included two groups; first group included 40 patients with persistently longstanding abnormal liver function test, in addition to 62 patients with history of hepatitis C who developed SVR. HCV RNA status was tested in serum by conventional RT-PCR and by real-time PCR in Peripheral Blood Mononuclear Cells (PBMCs). HBV DNA in PBMCs was done in first group only.
In first group, PCR in PBMCs was positive for HCV RNA in 4 patients with elevated liver enzymes and HBV DNA was positive in PBMCs in 3 patients. In patients with SVR, 7 patients were positive for HCV RNA in PBMCs.
Patients with long-standing abnormal results of liver-function tests with unknown etiology may have HCV RNA or HBV DNA in their PBMCs in the absence of anti-HCV antibodies, HBV markers, serum HBV DNA and serum HCV RNA.In Patients with SVR, HCV RNA in PBMCs is recommended to detect residual infection especially in those with high serum HCV RNA levels before treatment.

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    • "It is most likely that a viral reservoir remains in the liver [13]. Peripheral blood mononuclear cells (PBMCs) have been cited as a possible viral reservoir with previous studies suggesting that 9–26% of SVR patients may have residual virus in PBMCs [13] [14] [15] [16] [17] [18] [19]. However, HCV infection of PBMCs is controversial, with some studies demonstrating that there may not be true replicative infection within PBMCs and, rather, that the presence of viral RNA may be due circulating virions in the serum passively diffusing into cells [20] [21]. "
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    ABSTRACT: . Inflammatory gene expression in peripheral blood mononuclear cells (PBMCs) is altered in chronic Hepatitis C Virus (HCV) infection. Duration of changes after pegylated interferon- (peg-IFN-) based HCV treatment is unclear. Methods . PBMC mRNA expression of 184 inflammatory response genes was analyzed (nCounter GX Human Inflammation Kit, Nanostring) from peg-IFN treatment nonresponders (NR, n = 18 ), sustained virologic responders (SVR, n = 22 ), and spontaneous clearers (SC, n = 15 ). Logistic regression was used for comparison. Results . Median time from last treatment was 2 and 2.7 years in SVR and NR, respectively ( p = NS). Mean mRNA counts were significantly different for 42 and 29 genes comparing SVR to SC patients and NR to SC, respectively, and no genes comparing SVR to NR. Differential expression of 24 genes was significantly different in both SVR and NR groups compared to SC. Among these 24 acute and chronic inflammatory cascade genes, significant upregulation was noted for proinflammatory transcription regulators Fos , CEBPB , and MyD88 in SVR and NR compared to SC. HDAC4 was significantly downregulated in SVR and NR compared to the SC group. Conclusions . PBMC inflammatory gene expression patterns in SVR resemble NR more than SC patients. A generalized inflammatory response persists in PBMCs long after successful peg-IFN treatment for HCV infection.
    Journal of Immunology Research 11/2015; 2015(4):1-8. DOI:10.1155/2015/958231 · 2.93 Impact Factor
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    • "There is also controversy about the possible role of occult HCV infection, that is, detectable HCV-RNA in the liver or peripheral blood mononuclear cells in the absence of serum HCV-RNA [17, 18]. Indeed, it is conceivable that the virus, or part of it, may still be triggering B-cell proliferation, although it is not detected in the serum. "
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    ABSTRACT: Patients with chronic hepatitis C virus (HCV) can develop systemic cryoglobulinemic vasculitis. Combination of pegylated-interferon α and ribavirin is the first-line treatment of this condition. However, in case of severe or life-threatening manifestations, absence of a virological response, or autonomized vasculitis, immunotherapy (alone or in addition to the antiviral regimen) is necessary. Rituximab is to date the only biologic with a sufficient level of evidence to support its use in this indication. Several studies have demonstrated that rituximab is highly effective when cryoglobulinaemic vasculitis is refractory to antiviral regimen, that association of rituximab with antiviral regimen may induce a better and faster clinical remission, and, recently, that rituximab is more efficient than traditional immunosuppressive treatments. Some issues with regard to the optimal dose of rituximab or its use as maintenance treatment remain unsolved. Interestingly, in balance with this anti-inflammatory strategy, a recent pilot study reported the significant expansion of circulating regulatory T lymphocytes with concomitant clinical improvement in patients with refractory HCV-induced cryoglobulinaemic vasculitis using low dose of subcutaneous interleukin-2. This paper provides an updated overview on the place of immunotherapy, especially biologics, in the management of HCV-induced cryoglobulinaemic vasculitis.
    Clinical and Developmental Immunology 08/2012; 2012(5):315167. DOI:10.1155/2012/315167 · 2.93 Impact Factor

  • Value in Health 11/2006; 9(6). DOI:10.1016/S1098-3015(10)63352-9 · 3.28 Impact Factor
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