[Evaluation of persistence of IFN-alpha treatment response in chronic hepatitis C patients according with HCV-RNA presence in PBMC]

Abstract

Background: The current criterion of cure of chronic hepatitis C (CHC) is the absence of HCV-RNA in hepatocytes and peripheral blood mononuclear cells (PBMC), as these cells are considered for the place of protracted viral replication.

Purpose: Evaluation of HCV-RNA presence in serum, freshly isolated PBMC and cultured PBMC, taken from patients responding to interferon alfa2b therapy, after 42 months of follow-up. Fifty four adults with CHC was treated with interferon alfa-2b (IFN-alpha 2b). Evaluation of HCV-RNA presence in serum were performed using RT-PCR method, before the therapy, and after 6 and 18 months of follow-up. All patients received interferon alpha-2b for 6 months. After 18 months of follow-up, results of treatment (ALT activity and presence of HCV-RNA in serum) were retrospectively analyzed. In 10 of 54 patients (18.5%) normalization of ALT activity and negativization of HCV-RNA in serum were observed. After 42 months of follow-up, in these 10 patients, the presence of HCV-RNA in serum, in freshly isolated PBMC and cultured PBMC, were evaluated.

Results: After 42 months of follow-up, HCV-RNA was not found in serum of any patient. In 3 of 10 patients HCV-RNA was present in freshly isolated PBMC. After 3-day-culture of PBMC, HCV-RNA was found in another patient. After 6 days of culture, results of RT-PCR test were negative in all cases.

Conclusions: Absence of HCV-RNA in serum as well as in freshly isolated PBMC after 42 months of follow-up after the treatment of CHC, is not synonymous with eradication of virus. Three-day-culture of PBMC may be a valuable method, allowing for detection of subtreshold amounts of HCV. Longer, 6-day-culture seems to be invaluable diagnostically.