学术论文

      Occult HCV Infection (OCI) Diagnosis in Cirrhotic and Non-cirrhotic Naive Patients by Intra-PBMC Nested Viral RNA PCR

      Abstract:
      Background and Aims:Occult HCV infections (OCIs) include IgG antibody seronegative cryptogenic (COCIs),as well as seropositive secondary na(i)ve (SNOCIs) and experienced (SEOCIs) cases.We used peripheral-blood-mononuclear-cell (PBMC)-PCR to evaluate COCIs and SNOCIs prevalence,serum HCV spontaneous disappearance (SCSD) in na(i)ve cirrhotics and non-cirrhotics,intra-PBMC HCV-RNA strands in relation to cirrhosis density in na(i)ve non-viremia cases,and HCV-RNA seroconversion after 1 year of solitary naive intra-PBMC infection.Methods:The anti-HCV IgG antibodypositive na(i)ve-patients (n =785) were classified into viremic (n =673) and non-viremic [n =112,including non-cirrhotics (n =55) and cirrhotics (n =57)],and 62 controls without evidence of HCV-infection.Controls and post-HCV non-viremia cases (n =62+112 =174) were submitted to hepatic FibroscanElastography evaluation.All subjects (n =847) were screened for intra-PBMC HCV-RNA sense and antisense strands by nested-PCR.Results:Na(i)ve-OCI cases (4.84%)that were diagnosed by PBMC-PCR significantly raised the total numbers of HCV-infection to 714 (p =0.01).The percent positivity of SNOCIs (34.82%) was significantly higher than for asymptomatic-COCIs (3.125%,p =0.0001).Comparing PBMC-PCR with single-step-reverse-transcription (SRT)-PCR for identification of SCSD in na(i)ve IgG antibody-positive nonviremia patients (n =112) revealed a decline in SCSD prevalence by PBMC-PCR (from 14.27% to 9.3%),regardless of presence of hepatic cirrhosis (p =0.03).SCSD was found to be higher by PBMC-PCR in non-cirrhotics compared to cirrhotics (p =0.0001),with an insignificant difference when using SRT-PCR (p =0.45).Intra-PBMC HCV-RNA infection was significantly more frequent in cirrhotics compared to both non-cirrhotics and controls (p < 0.0005).An increased hepatic fibrosis density was recognized in intra-PBMC HCV-RNA infection with sense (p =0.0001) or antisense strand (p =0.003).HCV-RNA seroconversion was associated with intra-PBMC infection when both sense and antisense strands were detected (p =0.047).Conclusions:Intracellular HCV-RNA evaluation is crucial for diagnosing OCIs and addressing relapse probability.
      Author: Mohamed Darwish Ahmed Abd Alla [1] Saleh Ahmed Elibiary [1] George Y.Wu [2] Mostafa Kamel El-Awady [3]
      作者单位: Tropical Medicine Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt Department of Medicine, Division of Gastroenterology-Hepatology, University of Connecticut Health Center, Farmington, CT, USA Department of Microbial Biotechnology, National Research Center, Cairo, Egypt
      年,卷(期): 2017, 5(4)
      在线出版日期: 2017年12月18日
      基金项目: Financial support for this study was provided by the Faculty of Medicine at Al-Azhar University,National Research Center,by the Academy of Scientific Research and Technology Development Fund (Grant No.3365,to Mostafa K El-Awady).A grant from Alexion Corp.and the Herman Lopata Chair in Hepatitis Research is gratefully acknowledged