Detection of hepatitis C virus RNA in the peripheral blood mononuclear cells in patients with chronic hepatitis C and its relationship with effect of anti-viral treatment

Abstract

Objective To detect the change of hepatitis C virus (HCV) RNA in the peripheral blood mononuclear cells (PBMC) and serum of patients with chronic hepatitis C (CHC) during treatment with peg-interferon α-2a (Peg IFNα-2a) plus ribavirin (RBV), and to analyze the clinical significance of HCV RNA detection in PBMC. Methods The peripheral blood samples of 20 CHC patients who visited Department of Infectious Diseases in Guangzhou No.8 People's Hospital from June 2013 to December 2014, were collected during treatment with Peg IFNα-2a+ RBV at different time points (week 0, 2, 4, 12, 24, 36 and 48). Serum and PBMC were separated. Accurate fluorescence quantification assay (Cobas TaqMan real time polymerase chain reaction[PCR]) was used to detect HCV RNA level in serum, while real-time PCR and nest-PCR were applied to detect HCV RNA in PBMC. Categorical data were analyzed by χ2 test. Results Accurate fluorescence quantification of serum HCV RNA showed that HCV RNA level decline rapidly after treatment (F=148.06, P<0.01), and 18 patients achieved HCV RNA undetectable at week 12 of treatment. The positive rate of nest-PCR was higher than real-time PCR (all P<0.01). Comparison of HCV RNA levels in serum and PBMC from 20 cases found that, the clearance rate of HCV RNA in PBMC was postponed. Two patients whose HCV RNA in PBMC kept detectable relapsed at week 24 after end of treatment. Conclusions HCV RNA can be detected in PBMC of CHC patients and the positive rate of nest-PCR is higher than real-time PCR. Antiviral therapy is effective on HCV both inside and outside PBMC, but the clearance rate of HCV RNA in PBMC is postponed compared with that in serum. Slow clearance of HCV in PBMC may be a risk factor for relapse after end of treatment. Key words: Hepatitis C; Peripheral blood mononuclear cells; HCV RNA; Interferon