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No evidence of occult hepatitis C or E virus infections in liver‐transplant patients with sustained virological response after therapy with direct acting agents
Author(s) -
Del Bello Arnaud,
Abravanel Florence,
Alric Laurent,
Lavayssiere Laurence,
Lhomme Sébastien,
Bellière Julie,
Izopet Jacques,
Kamar Nassim
Publication year - 2019
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.13093
Subject(s) - medicine , occult , hepatitis c virus , hepatitis c , immunology , gastroenterology , virology , virus , pathology , alternative medicine
Background and Aims It has been recently suggested that occult hepatitis C virus (HCV) infection and hepatitis E virus (HEV) reactivation might occur after direct acting antiviral agent‐induced (DAA‐induced) sustained virological response (SVR). The aim of our study was to identify occult HCV and HEV infection in a cohort of organ transplant patients who had achieved SVR and had persistent elevation in liver‐enzyme levels. Patients and Method Sixty‐six liver and/or kidney transplant patients were treated with DAAs. All but one achieved SVR12. Twenty‐nine (8‐39) months post‐SVR12, 8 of the 65 patients (12.3%) who achieved SVR12 had persistently elevated liver enzyme levels. In 1 patient, this was related to hepatitis B virus reactivation. In the 7 remaining patients, blood samples (n = 7), liver biopsies ( n = 4), and peripheral blood mononuclear cells (PBMCs) ( n = 7) were collected simultaneously in order to identify occult HCV or HEV infection. Results Hepatitis C virus RNA and HEV RNA were not detected in serum, liver tissues, or PBMCs. No HEV reactivation was observed after HCV clearance in patients who had anti‐HEV IgG. Conclusion Our study suggests that there is no occult HCV or HEV infection in transplant patients after successful treatment of HCV infection with DAAs, even in patients with a persistent elevation of liver enzyme levels. However, due to the small number of patients included in our study, this finding should be confirmed in a larger cohort.