Age and Gender are Predictors for Occult Hepatitis C in Egyptian Sustained Responders to Directly Acting Antivirals

Yosef, Tarek; Hussein, Maha M.; Elzohary, Amr; George Michael, Tari M.A.

doi:10.21608/ejhm.2022.258684

Age and Gender are Predictors for Occult Hepatitis C in Egyptian Sustained Responders to Directly Acting Antivirals

Document Type : Original Article

Authors

10 Dr.Hegazy st. Mohandessin

10.21608/ejhm.2022.258684

Abstract

Background: Occult HCV infection (OCI) describes detectable viral RNA in the hepatocytes and in peripheral blood mononuclear cells (PBMCs) in the absence of conventional markers for HCV. The present study aimed to detect the prevalence of occult hepatitis C virus infection in patients who achieved a sustained virologic response (SVR) to direct- acting antiviral agents (DAAs) and to outline predictors of OCI. Patients and methods: This multicenter cross-sectional study included 50 males and 50 females seeking treatment for chronic hepatitis C patients without liver cirrhosis who were treated with combination of sofosbuvir (SOF) and daclatasvir (DCV) with or without ribavirin for three months and achieved SVR as proved by negative PCR after 12 weeks of the end of treatment. Twelve weeks after the end of treatment, HCV RNA was tested in PBMCs to detect OCI in patients with SVR. Logistic regression was used to find out factors affecting the presence of OCI. ROC curve was used to evaluate the performance of different tests to predict OCI. Results: Of the 100 patients, 12 (12%) had detectable HCV RNA in PBMCs after achieving SVR12 denoting presence of occult HCV infection. Age ≤45 years and male gender were significant predictors for occurrence of OCI. However, direct bilirubin ≥0.40 mg/dL was a significant predictor with low diagnostic performance.
Conclusion: OCI can persist in sustained responders to DAA therapy and the risk of OCI is more prevalent in males younger than 45 years. Age and direct bilirubin can be possible predictors for OCI.

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