Occult hepatitis C virus infection: what does it mean?

February 26, 2010

LIVER INTERNATIONAL

Authors: Pham, Tram N. Q.1; Coffin, Carla S.2; Michalak, Tomasz I.1

Source: Liver International, Volume 30, Number 4, April 2010 , pp. 502-511(10)

Publisher: Blackwell Publishing

Abstract:

Occult hepatitis C virus infection (OCI) is a recently identified entity of

which the existence became evident when nucleic acid amplification assays of

enhanced sensitivity were introduced for the detection of hepatitis C virus

(HCV) genome and its replication. This form of HCV infection has been found to

persist in the presence of antibodies against HCV and normal levels of liver

enzymes for years after spontaneous or antiviral therapy-induced resolution of

hepatitis C and, therefore, can be termed as secondary OCI. HCV RNA in OCI

circulate at fluctuating levels normally not exceeding 200 genome copies per

millilitre of serum or plasma, while low levels of virus genome and its

replicative intermediate RNA-negative strand are detectable in the liver and,

importantly, immune cells, which provide an opportunity to detect active virus

replication without the need for acquiring a liver biopsy. In addition to

secondary OCI, a form of OCI accompanied by persistently moderately elevated

serum liver enzymes in the absence of antibodies to HCV, which can be termed as

cryptogenic OCI, has also been described. The current understanding of the

nature and characteristics of OCI, methods and pitfalls of its detection, as

well as the documented and expected pathological consequences of OCI will be

summarized in this review.

Document Type: Research article

DOI: 10.1111/j.1478-3231.2009.02193.x

Affiliations: 1: Molecular Virology and Hepatology Research Group, Division of

BioMedical Sciences, Faculty of Medicine, Health Sciences Centre, Memorial

University, St 's, Newfoundland and Labrador, Canada 2: University of

Calgary Liver Unit, Division of Gastroenterology, University of Calgary,

Calgary, AB, Canada

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