Undetectable Hepatitis C Virus Research Articles

Clinical Outcomes of Sofosbuvir-Based Direct-Acting Antiviral Therapy in Kidney Transplant Recipients Infected with Hepatitis C Virus

Introduction Hepatitis C virus (HCV) infection has an adverse effect on patient and graft survival in kidney transplant recipients. In the past, treatment of HCV infection was not effective and at the same time carried high risk of acute rejection. However, new direct-acting antiviral (DAA) therapy has transformed treatment of HCV infection and resulted in high response rate. The aim of this study was to retrospectively examine the clinical outcomes of HCV-infected kidney transplant recipients at our center who were treated with DAA therapy. Methods We identified fifteen kidney transplant recipients who had positive HCV PCR post transplantation and got treated with DAA therapy. Two patients were co-infected with hepatitis B virus and received entecavir in addition to DAA. Results The mean age of treated patients was 48 years (±12.6). 10 patients (67%) were males. 3 of the 15 patients also had liver transplant. 67% of patients acquired HCV infection post transplantation. 7 patients (47%) had HCV genotype 1, 5 patients (33%) genotype 4 and 3 patients (20%) genotype 3. None of the patients were positive for HIV infection. All patients had estimated GFR more than 30 ml/min/1.73 m2. Patients were treated with sofosbuvir-based regimen: 8 patients (53%) with ledipasvir/sofosbuvir, 6 patients (40%) with daclatasvir/sofosbuvir and 1 patient with simeprevir/sofosbuvir. The duration of DAA treatment was 3-6 months. All patients had undetected HCV at 8 weeks of treatment and 12-week sustained virologic response (SVR). The treatment was well tolerated and there was no significan graft dysfunction in any of the treated patients as shown in the figure below.Conclusion 100% of HCV-infected kidney transplant recipients at our center achieved 12-week SVR with Sofosbuvir-based DAA therapy with no major side effects or significant graft dysfunction.

Assessment of Hepatitis C Virus RNA in Peripheral Blood Mononuclear Cells as a Predictor of Response to Pegylated-Interferon and Ribavirin: A Cohort Study

Background: Sustained virologic response (SVR) to pegylated-interferon (PegIFN) and ribavirin (RBV) in hepatitis C virus (HCV)-infected patients could be predicted by detection of serum HCV RNA whereas detection of HCV RNA in other reservoirs such as peripheral blood mononuclear cells (PBMCs) for prediction of treatment response is still a mystery. Objectives: This study aimed at assessing the prediction of SVR by detection of HCV RNA in PBMCs or serum in patients during treatment. Methods: In a cohort study (2011 to 2014), 100 chronic HCV patients at Tehran Hepatitis Center were treated with PegIFN and RBV. Serum HCV RNA level was measured at baseline, 4, 12, and 24 weeks during treatment and at 24 weeks after termination of treatment. Meanwhile, HCV RNA was evaluated in PBMCs at weeks 4, 12, and 24 during the treatment. Results: Out of 100 patients treated in this study, 91 completed the course of treatment. Most patients were young males infected with HCV genotype 1. Cirrhosis and previous history of treatment was found in 16.5% and 26.5% of patients. Sustained virologic response was achieved in 65 (71.4%) patients. Among baseline parameters, only female gender was significantly associated with SVR. Undetectable serum HCV RNA at week 4 (OR = 4.74) and week 12 (OR = 11.63) of treatment predicted SVR rate while the same was not true for detection of serum HCV RNA at week 24 of treatment. Moreover, detection of HCV RNA in PBMCs at weeks 4 and 12 of treatment was not associated with the rate of SVR, while absence of HCV RNA in PBMCs at week 24 of treatment was associated with SVR (OR = 4.55). Conclusions: Detection of HCV RNA in PBMCs, especially at week 24 of treatment with PegIFN and RBV, could be considered as an additional marker for prediction of treatment response. It is recommended to assess HCV on-treatment kinetic in PBMCs of patients treated with direct-acting antiviral agents for prediction of treatment response.

Meta-analysis of hepatocellular carcinoma incidence in patients who have obtained a sustained virologic response after antiviral therapy for hepatitis C.

1551Background: Hepatitis C virus (HCV) is a risk factor for development of hepatocellular carcinoma (HCC). Patients (pt) with HCV can achieve a sustained virologic response (SVR; undetectable HCV ...

Chronic Hepatitis C Virus Infection Increases Mortality From Hepatic and Extrahepatic Diseases: A Community-Based Long-Term Prospective Study

The study aimed to evaluate the risk of hepatitis C virus (HCV) infection on hepatic and extrahepatic deaths. A cohort of 23 820 adults aged 30-65 years old were enrolled during 1991-1992. The seromarkers hepatitis B surface antigen (HBsAg), anti-HCV, and serum HCV RNA levels at study entry were tested. The vital status was ascertained through computerized linkage with national death certification profiles from 1991 to 2008. There were 19,636 HBsAg-seronegatives, including 18,541 anti-HCV seronegatives and 1095 anti-HCV seropositives. Among anti-HCV seropositives, 69.4% had detectable serum HCV RNA levels. There were 2394 deaths that occurred during an average follow-up period of 16.2 years. Compared with anti-HCV seronegatives, anti-HCV seropositives had higher mortality from both hepatic and extrahepatic diseases, showing multivariate-adjusted hazard ratio (95% confidence interval) of 1.89 (1.66-2.15) for all causes of death; 12.48 (9.34-16.66) for hepatic diseases; 1.35 (1.15-1.57) for extrahepatic diseases; 1.50 (1.10-2.03) for circulatory diseases; 2.77 (1.49-5.15) for nephritis, nephrotic syndrome, and nephrosis; 4.08 (1.38-12.08) for esophageal cancer; 4.19 (1.18-14.94) for prostate cancer; and 8.22 (1.36-49.66) for thyroid cancer. Anti-HCV seropositives with detectable HCV RNA levels had significantly higher mortality from hepatic and extrahepatic diseases than anti-HCV seropositives with undetectable HCV RNA. Monitoring HCV RNA in anti-HCV seropositives is essential for the prediction of mortality associated with hepatitis C.

Persistence of Hepatitis C RNA in Liver Allografts Is Associated with Histologic Progression Independent of Serologic Viral Clearance

Background. Hepatitis C virus (HCV) nondetectability in the liver may predict a sustained viral response (SVR) in patients with an end of treatment response. HCV RNA can be detected in liver tissue by in situ hybridization (ISH). Aim. To determine if HCV nondetectability in liver allografts by ISH can predict SVR in patients who cleared virus serologically on treatment. Methods. Twenty five patients with undetectable serum HCV on Interferon/Ribavirin therapy for HCV recurrence post liver transplant (LT) were studied. All had biopsies at 4 months post LT (baseline) and follow up with HCV ISH analysis performed. Results. 10 were ISH positive (group 1); 15 were ISH negative (group 2). Groups 1 and 2 had similar patient, donor, and viral characteristics at LT, as well as treatment duration at the time of the ISH assayed liver biopsy (13 ± 16 versus 10 ± 4 months P = .24). However, group 1 had longer total treatment duration (24 ± 10 versus 14 ± 5 months, P = .001). Eight (80%) group 1 and 9 (60%) group 2 patients achieved SVR. Mean grade and stage (modified Ishak score) were similar at 4 months, however, group 1 had higher grade (3 ± 1.7 versus 1.6 ± 1.3, P = .039) and stage (1.4 ± 1.4 versus 0.5 ± 0.6, P = .084) on the ISH assayed biopsy, after similar post LT intervals (23 ± 10 versus 24 ± 12 months, P = .91). Conclusion. Allograft HCV ISH nondetectability does not predict SVR in treatment responsive HCV recurrence, but is associated with less severe histologic disease.

Hepatitis C virus (HCV) specific immune responses in anti-HCV positive patients without hepatitis C viraemia

BACKGROUND/AIMSMost patients infected with hepatitis C virus (HCV) develop chronic infection and persistent viraemia. The immune mechanisms responsible for resolution of viraemia remain poorly understood. HCV specific humoral and cellular...