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Presence of HCV‐RNA after ultracentrifugation of serum samples during the follow‐up of chronic hepatitis C patients with a sustained virological response may predict reactivation of hepatitis C virus infection
Author(s) -
CASTILLO I.,
BARTOLOMÉ J.,
QUIROGA J. A.,
BARRIL G.,
CARREÑO V.
Publication year - 2009
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2009.04066.x
Subject(s) - ultracentrifuge , rna , medicine , hepatitis c virus , virology , virus , hepatitis c , viral load , chronic hepatitis , immunology , biology , gene , biochemistry
Summary Background Concentration of viral particles by ultracentrifugation of serum prior to PCR allows detection of hepatitis C virus (HCV) RNA in patients with undetectable viral RNA by conventional PCR assays. Aim To analyse if HCV‐RNA is detected after serum ultracentrifugation in chronic hepatitis C patients with a sustained virological response to antiviral therapy (defined as serum HCV‐RNA negativity by conventional assays 6 months after the end of therapy). Methods HCV‐RNA was tested using real‐time PCR in ultracentrifuged sera collected during the post‐treatment follow‐up (mean: 42 ± 27 months) in 57 sustained virological responders (SVR). Results After serum ultracentrifugation, HCV‐RNA was detected on at least one occasion during the follow‐up in 29/57 (51%) SVR. Thirteen (23%) of these 57 SVR suffered a reactivation 18 ± 8 months after the end of therapy (reappearance of serum HCV‐RNA detectable by conventional assays). Among reactivated patients, 11/13 (85%) had HCV‐RNA in ultracentrifuged serum samples (detectable 10 ± 5 months before reactivation), while HCV‐RNA was positive after ultracentrifugation in 18/44 (41%) long‐term SVR ( P = 0.01). Persistence of detectable HCV‐RNA after serum ultracentrifugation was associated with reactivation ( P = 0.001). Conclusions Serum ultracentrifugation prior to PCR allows detection of HCV‐RNA in SVR and its persistence may predict late reactivation.