Abstract
Several studies have reported the persistence of HCV RNA in liver and/or peripheral blood mononuclear cells (PBMCs) in spite of undetectable viremia in patients who have achieved sustained virological response (SVR). This event, defined as occult HCV infection, remains controversial and low titers of persistent virus may be underestimated because it has not yet been analyzed by a highly sensitive test such as droplet digital PCR (ddPCR). This method provides an alternate ultra-sensitive detection technique for very low numbers of copies of viral RNA or DNA. The aim of this study was to evaluate the persistence of HCV in HIV-coinfected patients with long-term SVR using ddPCR. For each patient, the presence of HCV RNA in serum and PBMCs at baseline was determined by nested RT-ddPCR. Patients with HCV RNA in PBMCs at baseline were followed until the end of the study. One hundred and twenty-three patients were analyzed for persistence of HCV RNA in serum and PBMCs. Persistence of HCV was not found in serum in any patient. HCV RNA was detected in PBMCs in one patient (0.81%; 95% CI: 0.04–3.94) and resolved spontaneously during follow-up. Persistence of HCV RNA in PBMCs is not a common event in HIV/HCV co-infected patients with long-term SVR evaluated by RT-ddPCR.
Highlights
The objective of chronic HCV infection (CHC) therapy is to achieve sustained virological response (SVR), defined as absence of HCV RNA in serum at twelve or twenty-four weeks after successful treatment[1]
To the best of our knowledge, this is the first study to evaluate the persistence of HCV in peripheral blood mononuclear cells (PBMCs) after achieving long-term SVR using an ultra-sensitive method such as Droplet digital PCR (ddPCR)
HCV RNA persistence in PBMCs was found in 1 patient who had achieved SVR with sustained clearance of serum HCV RNA for 8 years
Summary
The objective of chronic HCV infection (CHC) therapy is to achieve sustained virological response (SVR), defined as absence of HCV RNA in serum at twelve or twenty-four weeks after successful treatment[1]. Several studies have reported that the persistence of HCV RNA in the liver and/or peripheral blood mononuclear cells (PBMCs) in patients who have achieved SVR can lead to late relapses[2,3,4,5,6] This unusual event is recognized as occult HCV infection and defined as the presence of HCV RNA in liver tissue or PBMCs despite undetectable viremia[7]. This situation remains controversial as several studies have been unable to confirm the presence of HCV RNA in PBMCs or liver tissue in patients with long-term viral clearance[8,9,10].
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