Avatar universal

No evidence of occult hepatitis C

No evidence of occult hepatitis C virus (HCV) infection in serum of HCV antibody-positive HCV RNA-negative kidney-transplant patients.

Nicot F, Kamar N, Mariamé B, Rostaing L, Pasquier C, Izopet J.
INSERM, U563, Toulouse, France.

Persistence of hepatitis C virus (HCV) in patients who cleared HCV is still debated. Occult HCV infection is described as the presence of detectable HCV RNA in liver or peripheral blood mononuclear cells (PBMCs) of patients with undetectable plasma HCV-RNA by conventional PCR assays. We have assessed the persistence of HCV in 26 kidney-transplant patients, followed up for 10.5 years (range 2-16), after HCV elimination while on hemodialysis. If HCV really did persist, arising out of the loss of immune control caused by institution of the regimen of immunosuppressive drugs after kidney transplantation, HCV reactivation would have taken place. Their immunosuppression relied on calcineurin inhibitors (100%), and/or steroids (62%), and/or antimetabolites (94%). An induction therapy, given to 22 patients, relied on rabbit antithymocyte globulin (59%) or anti-IL2-receptor blockers (32%). All patients had undetectable HCV RNA as ascertained by several conventional tests. At the last follow-up, no residual HCV RNA was detected in the five liver biopsies, the 26 plasma, and in the 37 nonstimulated and 24 stimulated PBMCs tested with an ultrasensitive RT-PCR assay (detection limit, 2 IU/ml). No biochemical or virologic relapse was seen during follow-up. The absence of HCV relapse in formerly HCV-infected immunocompromised patients suggests the complete eradication of HCV after its elimination while on dialysis.
7 Responses
179856 tn?1333547362
Most of it is over my head but it certainly is spectacular news.  I never liked the concept that we weren't "cured" and it was just "hiding" anyway :)  

Adios HCV! Get out and stay out!
Avatar universal
I found this article interesting as well as encouraging. It addresses the issue of persistent HCV in SVRs that, under immune suppression drugs therapy, might reulst in relapse. In this study no residual virus could be detected in serum, liver tissue or peripheral blood mononuclear cells both non-stimulated and stimulated. So in this study there simply was no detectable virus anywhere.
388154 tn?1306361691
I have knewed it all the time my intuition told me it was gone, still thx for posting.
All this hiding never cured talk thats been going on lately can make anybody daupt the cure word.

For me its cured period, specially since even the antibodies can dissapear after a long time.


My believe is that it is those freaking 615iu tests that has screwed it up some times.
People they thought was UND never really was, just my 5 cents on the matter.

412873 tn?1329174455
~~after HCV elimination while on hemodialysis.~~

Sorry if this is a dumb question...but could the hemodialysis have anything to do with the results?  

As per usual, Mike...great info. Thanks for posting, but I've always been curious about this.

Avatar universal
thanks mike. very interesting article. it is nice to know there really is a "cure".

i always had that question in the back of my mind "is the HCV completely gone, will it return"

it was in the back of my mind with these other unanswered questions:

did oswald shoot JFK and did he act alone?
is elvis really dead?

well at least we know that in this case HCV & Elvis have left the building
548668 tn?1394187222
Thanks Mike;  articles like this are always heartening, especially as my doc wrote on a recent referral that my HVC was 'in remission' - (doh, what a psychological let-down after a hard-earned SVR).   I didn't notice it until I left the office, but will certainly be debating the issue with him next time I see him!!
717272 tn?1277590780
Thanks, Mike.  I'm encouraged.  The concept that there might be something left behind that might pop up under immunosuppressive therapy for rheumatoid arthritis or psoriasis (who knows what's going to happen to us when we are older) is too awful to think about.  I hope there will be more studies like this to put occult hepatitis ideas to rest.
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