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Abdul Rahman SNF, Hamzah HA, Mustafa Mahmud MIA, Mat Harun N. Molecular Analysis and Ex Vivo Infectivity of Seronegative Occult Hepatitis C Virus: A Study in Single Haemodialysis Centre. Malays J Med Sci 2024; 31:30-42. [PMID: 38694575 PMCID: PMC11057825 DOI: 10.21315/mjms2024.31.2.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/02/2023] [Indexed: 05/04/2024] Open
Abstract
Background In occult hepatitis C virus infection (OCI), hepatitis C virus ribonucleic acid (HCV RNA) is detectable in peripheral blood mononuclear cells (PBMCs) but is not evident in serum or plasma. Understanding of OCI in patients with seronegative anti-HCV antibodies is limited. Methods In this study, six HCV isolates from haemodialysis (HD) patients with seronegative OCI were identified by molecular assays and phylogenetic analysis. The virus infectivity was assessed ex vivo using a primary naïve PBMC culture system. HCV isolates obtained from the PBMCs of 10 patients with chronic HCV infection (CCI) were characterised concurrently and used as positive controls in the cell culture. Results Sequence analysis of the 5' untranslated region (UTR) and non-structural 5B (NS5B) region revealed that HCV genotype 3 was the most prevalent virus type in both the OCI and CCI groups. One of the occult HCV isolates was identified as a mixed type. The mean viral load (log10 RNA copies/106 cells) in the PBMC samples of the OCI group (M = 3.4, SD = 0.7) was lower than that of the CCI group (M = 4.6, SD = 1.7). Upon culture, de novo OCI-HCV replicates were detected in five out of six naïve PBMC cultures. Analysis of the replicates showed a single guanine addition in the domain III of 5'-UTR but the overall molecular structure was retained. Conclusion Seronegative OCI is an active form of infection that replicates at a low level in PBMCs. Seronegative OCI may share the same route of transmission as CCI. The retained viral competency may have an implication for its persistence.
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Affiliation(s)
- Siti Nurul Fazlin Abdul Rahman
- Microbiology Unit, Department of Basic Medical Sciences, Kulliyyah of Medicine, International Islamic University Malaysia, Pahang, Malaysia
| | - Hairul Aini Hamzah
- Microbiology Unit, Department of Basic Medical Sciences, Kulliyyah of Medicine, International Islamic University Malaysia, Pahang, Malaysia
| | - Mohammed Imad A. Mustafa Mahmud
- Microbiology Unit, Department of Basic Medical Sciences, Kulliyyah of Medicine, International Islamic University Malaysia, Pahang, Malaysia
| | - Noraihan Mat Harun
- Molecular and Biochemistry Unit, Department of Basic Medical Sciences, Kulliyyah of Medicine, International Islamic University Malaysia, Pahang, Malaysia
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Choobin H, Bamdad T, Shekarabi M. The pattern of antiviral protein expression induced by interferon λ1 in peripheral blood mononuclear cells of patients with chronic hepatitis C virus infection. Arch Virol 2020; 165:583-592. [PMID: 31927635 DOI: 10.1007/s00705-019-04438-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 09/12/2019] [Indexed: 12/28/2022]
Abstract
Interferon lambda was discovered in recent years to be an antiviral agent, and research on different aspects of this antiviral factor in viral infection and investigations of its effectiveness are also progressing. The immunological effects of interferon lambda on different cell populations is not precisely known, which may be due to its use of a heterodimeric receptor consisting of IL-10R2 and IFN-λR1, which are not broadly expressed in all types of cells. In the present study, signaling by interferon lambda and its effect on the expression of hepatitis C virus (HCV) proteins were measured, and the expression pattern of some antiviral proteins and IL-10 levels were investigated in peripheral blood mononuclear cells (PBMCs). PBMCs were isolated from 50 patients with chronic genotype 1a HCV infection and 10 healthy individuals as controls. The PBMCs were treated with various doses of interferon lambda at different times of cultivation. Real-time PCR was used for relative quantification of Mxa, PKR, OAS, ISG15 and HCV core mRNAs. Expression of the NS5A protein was measured by flow cytometry, and IL-10 production was assessed by ELISA. A significant increase in the expression of mRNA encoding antiviral proteins and a decrease in the expression of mRNAs encoding the HCV core protein were observed when cells were treated with interferon lambda in an intermittent manner. The expression of HCV NS5A protein and interleukin 10 levels were also lower than in the control group. It was shown that the maximum antiviral effect of interferon lambda in PBMCs is dependent on the dose and treatment time.
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Affiliation(s)
- Hamzeh Choobin
- Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Taravat Bamdad
- Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mehdi Shekarabi
- Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran.
- Department of Immunology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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Wang Y, Rao H, Chi X, Li B, Liu H, Wu L, Zhang H, Liu S, Zhou G, Li N, Niu J, Wei L, Zhao J. Detection of residual HCV-RNA in patients who have achieved sustained virological response is associated with persistent histological abnormality. EBioMedicine 2019; 46:227-235. [PMID: 31345785 PMCID: PMC6711338 DOI: 10.1016/j.ebiom.2019.07.043] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/15/2019] [Accepted: 07/16/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Whether achieving sustained virological response (SVR) in patients with hepatitis C attains complete elimination of hepatitis C virus (HCV) is unknown, because occult HCV infection (OCI), defined as the detection of HCV-RNA in hepatocytes or peripheral blood mononuclear cells (PBMC) in absence of serum HCV-RNA, may occur. We thus investigated the prevalence and clinical relevance of OCI. METHODS Subjects from three hospitals who had achieved serum HCV clearance, including 60 of Direct-acting antiviral agents (DAAs) induced SVR, 50 of pegylated interferon plus ribavirin (PR) induced SVR, and 30 of spontaneous resolution, were subjected to detect HCV-RNA in liver by robust RNAscope assay and PBMC by qPCR. Paired liver biopsies at baseline and at SVR24 were analyzed. RESULTS OCI was detected in 16 of 140 subjects (11.4%), with 15.0% in DAA-based group, 10.0% in PR group and 6.7% in spontaneously resolved group. In DAA-based subgroups, the incidence of OCI was gradually increased in group of solely DAA(s) therapy, combining DAA and PR therapy and combining DAA and ribavirin therapy. OCI is more frequent in patients with genotype 3. No correlation between baseline viral load, interleukin-28B genotype, baseline transaminases, post-SVR transaminases and OCI were found. However, OCI was significantly linked with severity of fibrosis and active inflammation at post-SVR, even considering basal fibrosis status. In addition, both the magnitude and the frequency of fibrosis regression were lower in patients with OCI than in those without OCI. In the multivariate analysis, PR therapy was identified an independent negative prognostic factor for both hepatic inflammation (P = .022) and fibrosis regression (P = .015). Importantly, we found HCV relapse in one of the OCI patients at 48 weeks after the end of PR treatment. CONCLUSIONS HCV-RNA can persist in hepatocytes and/or PBMC in a certain of patients who achieved spontaneous or treatment-induced HCV RNA clearance from serum and associated with persistent histological abnormality. Our findings provide new insights into cure of HCV and could influence the following-up scenario after SVR.
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Affiliation(s)
- Yijin Wang
- Department of Pathology and Hepatology, the 5th Medical Center, Chinese PLA General Hospital, China
| | - Huiying Rao
- Peking University Hepatology Institute, Peking University People's Hospital, Peking University Health Science Center, Beijing, China
| | - Xiumei Chi
- Department of Hepatology, the First Hospital of Jilin University, Changchun, China
| | - Boan Li
- Center for Clinical Laboratory, the 5th Medical Center, Chinese PLA General Hospital, China
| | - Hongyang Liu
- Department of Pathology and Hepatology, the 5th Medical Center, Chinese PLA General Hospital, China
| | - Liyuan Wu
- Department of Pathology and Hepatology, the 5th Medical Center, Chinese PLA General Hospital, China
| | - Hao Zhang
- Center for Clinical Laboratory, the 5th Medical Center, Chinese PLA General Hospital, China
| | - Shuhong Liu
- Department of Pathology and Hepatology, the 5th Medical Center, Chinese PLA General Hospital, China
| | - Gaungde Zhou
- Department of Pathology and Hepatology, the 5th Medical Center, Chinese PLA General Hospital, China
| | - Na Li
- Advanced Cell Diagnostics, 3960 Point Eden Way, Hayward, CA 94545, USA
| | - Junqi Niu
- Department of Hepatology, the First Hospital of Jilin University, Changchun, China.
| | - Lai Wei
- Beijing Tsinghua Changgung Hospital, Tsinghua University, China.
| | - Jingmin Zhao
- Department of Pathology and Hepatology, the 5th Medical Center, Chinese PLA General Hospital, China.
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Abstract
Donor-derived infections are defined as any infection present in the donor that is transmitted to 1 or more recipients. Donor-derived infections can be categorized into 2 groups: "expected" and "unexpected" infections. Expected transmissions occur when the donor is known to have an infection, such as positive serology for cytomegalovirus, Epstein Barr virus, or hepatitis B core antibody, at the time of donation. Unexpected transmissions occur when a donor has no known infection before donation, but 1 or more transplant recipients develop an infection derived from the common donor. Unexpected infections are estimated to occur in far less than 1% of solid organ transplant recipients. We will review the epidemiology, risk factors, and approaches to prevention and management of donor-derived viral infectious disease transmission in liver transplantation.
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Martínez-Rodríguez MDLL, Uribe-Noguez LA, Arroyo-Anduiza CI, Mata-Marin JA, Benitez-Arvizu G, Portillo-López ML, Ocaña-Mondragón A. Prevalence and risk factors of Occult Hepatitis C infections in blood donors from Mexico City. PLoS One 2018; 13:e0205659. [PMID: 30339689 PMCID: PMC6195272 DOI: 10.1371/journal.pone.0205659] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 09/30/2018] [Indexed: 12/16/2022] Open
Abstract
Background The circulatory system is the main mechanism for transmission of the Hepatitis C Virus (HCV). A new class of HCV infections, Occult HCV infection (OCI), is defined as the presence of HCV-RNA in hepatocytes with the absence of HCV in the serum/plasma utilizing current laboratory assays. Different groups have reported the prevalence of OCI; however, its associated risk factors have not been established. In Mexico, there are no reports about OCI, so the objective of our study was to determine the prevalence of OCI in total blood donors in Mexico City, as well as its associated risk factors. Methods Blood donors that were considered eligible for donation, according to NOM 253-SSA1-2012, were randomly selected. Demographic data was collected from 1,037 donors. Plasma and peripheral blood mononuclear cells were assessed for HCV-RNA. The presence of HCV-RNA was determined by nested PCR for the 5'-UTR region. Logistic regression was used to calculate the odds ratio (OR) and 95% confidence interval (95%CI) to determine the level of association. Results The prevalence of OCI was 3.4% among blood donors. Homosexual relationships (OR = 5.52, 95%CI: 1.53–19.92, p<0.05) and acupuncture (OR = 3.56, 95%CI: 1.41–8.98, p<0.05) were significantly associated with OCI. Conclusion There is a significant presence of OCI in the blood donor population in Mexico City. The main risk factors for OCI transmission are homosexual relationships and acupuncture. This study supports the increased use of sensitive and specific screening tests for blood bank testing.
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Affiliation(s)
- María de la Luz Martínez-Rodríguez
- Unidad de Investigación Médica en Inmunología e Infectología, Centro Médico Nacional “La Raza”, Delegación 2 Noreste del D.F., Instituto Mexicano del Seguro Social, Mexico City, Mexico
- * E-mail:
| | - Luis A. Uribe-Noguez
- Unidad de Investigación Médica en Inmunología e Infectología, Centro Médico Nacional “La Raza”, Delegación 2 Noreste del D.F., Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Carla I. Arroyo-Anduiza
- Banco Central de Sangre, Centro Médico Nacional “La Raza”, Delegación 2 Noreste del D.F., Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - José Antonio Mata-Marin
- Hospital de Infectología, Centro Médico Nacional “La Raza”, Delegación 2 Noreste del D.F., Instituto Mexicano del Seguro Social. Mexico City, Mexico
| | - Gamaliel Benitez-Arvizu
- Banco Central de Sangre, Centro Médico Nacional “Siglo XXI”, Delegación Sur, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - María L. Portillo-López
- Banco Central de Sangre, Centro Médico Nacional “Siglo XXI”, Delegación Sur, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Alicia Ocaña-Mondragón
- Unidad de Investigación Médica en Inmunología e Infectología, Centro Médico Nacional “La Raza”, Delegación 2 Noreste del D.F., Instituto Mexicano del Seguro Social, Mexico City, Mexico
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Levitsky J, Formica RN, Bloom RD, Charlton M, Curry M, Friedewald J, Friedman J, Goldberg D, Hall S, Ison M, Kaiser T, Klassen D, Klintmalm G, Kobashigawa J, Liapakis A, O'Conner K, Reese P, Stewart D, Terrault N, Theodoropoulos N, Trotter J, Verna E, Volk M. The American Society of Transplantation Consensus Conference on the Use of Hepatitis C Viremic Donors in Solid Organ Transplantation. Am J Transplant 2017; 17:2790-2802. [PMID: 28556422 DOI: 10.1111/ajt.14381] [Citation(s) in RCA: 244] [Impact Index Per Article: 34.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 05/12/2017] [Accepted: 05/18/2017] [Indexed: 01/25/2023]
Abstract
The availability of direct-acting antiviral agents for the treatment of hepatitis C virus (HCV) infection has resulted in a profound shift in the approach to the management of this infection. These changes have affected the practice of solid organ transplantation by altering the framework by which patients with end-stage organ disease are managed and receive organ transplants. The high level of safety and efficacy of these medications in patients with chronic HCV infection provides the opportunity to explore their use in the setting of transplanting organs from HCV-viremic patients into non-HCV-viremic recipients. Because these organs are frequently discarded and typically come from younger donors, this approach has the potential to save lives on the solid organ transplant waitlist. Therefore, an urgent need exists for prospective research protocols that study the risk versus benefit of using organs for hepatitis C-infected donors. In response to this rapidly changing practice and the need for scientific study and consensus, the American Society of Transplantation convened a meeting of experts to review current data and develop the framework for the study of using HCV viremic organs in solid organ transplantation.
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Affiliation(s)
| | | | - R D Bloom
- University of Pennsylvania, Philadelphia, PA
| | - M Charlton
- Intermountain Medical Center, Salt Lake City, UT
| | - M Curry
- Beth Israel Deaconess Medical Center, Boston, MA
| | | | - J Friedman
- Optum Population Health Solutions, Minneapolis, MN
| | - D Goldberg
- University of Pennsylvania, Philadelphia, PA
| | - S Hall
- Baylor University Medical Center, Dallas, TX
| | - M Ison
- Northwestern University, Chicago, IL
| | - T Kaiser
- University of Cincinnati, Cincinnati, OH
| | - D Klassen
- United Network of Organ Sharing, Richmond, VA
| | - G Klintmalm
- Baylor University Medical Center, Dallas, TX
| | | | | | | | - P Reese
- University of Pennsylvania, Philadelphia, PA
| | - D Stewart
- United Network of Organ Sharing, Richmond, VA
| | - N Terrault
- University of California San Francisco, San Francisco, CA
| | | | - J Trotter
- Baylor University Medical Center, Dallas, TX
| | - E Verna
- Columbia University, New York, NY
| | - M Volk
- Loma Linda University, San Diego, CA
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