HCV RNA in peripheral blood mononuclear cells (PBMCs) as a predictor of the response to antiviral therapy in chronic hepatitis C

BackgroundHepatitis C virus (HCV) has been found to infect peripheral blood mononuclear cells (PBMCs), using them as a reservoir, which might contribute to the development of resistance to treatment.ObjectivesTo study hepatitis virus C (HCV) RNA in peripheral blood mononuclear cells (PBMCs) of patients with chronic HCV infection, and explore the relationship between the HCV RNA in the PBMCs and response to interferon (IFN) therapy.MethodsTwenty-five patients with chronic viral hepatitis C were included. The HCV RNA in PBMCs and serum was detected after 12 weeks of initializing interferon treatment, at the end of treatment, and 24 week and 1 year follow up after the end of the treatment. At the end of the treatment course, patients who were found to have positive PCR test for HCV RNA in PBMCs were subdivided into two groups, one group continues to receive IFN therapy while the other group stops. The HCV RNA in PBMCs and serum was detected by RT-PCR using the Amplicor HCV 2.0 assay.ResultsAll patients had negative serum PCR test for HCV RNA at the end of treatment, nevertheless HCV RNA was detected in PBMCs of approximately 32% of these patients. Patients who tested positively for HCV RNA in PBMCs at the end of treatment had an overall significantly higher relapse rate (50%) when compared with patients who tested negatively for HCV RNA in both serum and PBMCs at the end of treatment (6%). Patients with positive HCV RNA in their PBMCs who continue to receive interferon based treatment for further six months had a lower relapse rate (25%) when compared with similar patients who stopped interferon treatment at the 48th week (75%).ConclusionDetection of HCV RNA in PBMCs may be important to assess the virological response to interferon treatment and to predict relapse after antiviral therapy and may be taken as a reference to formulate the duration of antiviral therapy in chronic hepatitis C.