HCV Continues to Replicate in the Livers of Patients with Sustained Response to

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HCV Continues to Replicate in the Livers of Patients with Sustained

Response to Therapy

By Liz Highleyman

Chronic hepatitis C patients who achieve a sustained virological

response (SVR) to interferon-based therapy - continued undetectable

HCV RNA 6 months after the completion of treatment - are widely

considered to be " cured. "

However, according to a report in the November 15, 2006, issue of

Clinical Infectious Diseases, the hepatitis C virus (HCV) may

continue to replicate in the livers of such individuals.

Spanish researchers assessed the presence of both positive-strand and

negative-strand HCV RNA in the livers of 20 sustained responders

whose response persisted for a mean of 47.4 months after the end of

treatment. HCV genetic material was measured by PCR and in situ

hybridization in post-treatment liver biopsy samples (obtained a mean

35.4 months after therapy) and in peripheral blood mononuclear cells

(PBMCs).

Results

Positive-strand HCV RNA was found in 19 of 20 liver biopsy specimens

(95%).

Negative-strand HCV RNA was found in 15 of the 19 samples (79%) that

had positive-strand HCV RNA.

These results were confirmed by in situ hybridization.

13 of 20 PBMC samples (65%) had detectable positive-strand HCV RNA.

Negative-strand HCV RNA was detected in 12 of the 13 PBMC samples

(92%) with positive-strand HCV RNA.

Liver necro-inflammation was still present in the post-treatment

liver biopsy specimens of 15 patients, and fibrosis was present in 7.

Nevertheless, liver damage improved in all but 2 patients.

Conclusion

" HCV persisted and replicated in the livers and peripheral blood

mononuclear cells of most sustained responders, " the authors

concluded. " Thus, these patients did not experience HCV infection

clearance, despite apparent clinical disease resolution. "

12/15/06

Reference

I Castillo, E -Inigo, J M -Alcorocho, and others.

Hepatitis C virus replicates in the liver of patients who have a

sustained response to antiviral treatment. Clinical Infectious

Diseases 43(10): 1277-1283. November 15, 2006.