Study on the Presence of HCV RNA in PBMC as Compared with Plasma of Hepatitis C Patients after Treatment

Background and Aims: Hepatitis C virus is one of the viral infections which is mainly transmitted by blood transfusion. Patients with thalassaemia frequently need blood transfusion and are in danger of HCV infection. In most cases of infection (85%) the virus evades the immune system and establishes a chronic infection that may lead to cirrhosis and liver carcinoma. Liver is the main site of HCV replication HCV RNA has been detected in circulating extra hepatic sites, such as in peripheral blood mononuclear cells (PBMC) .It has been proposed that PBMC could be the source of recurrent HCV infection. The aim of this study was to investigate the presence of HCV RNA in PBMCs of thalassaemia patients with hepatitis C after antiviral treatment. Materials and Methods: About 261 (179 with and 82 without thalassaemia) patients with HCV infection after treatment, 20 patients with HCV infection without treatment and 20 healthy samples as control groups were analyzed in this study. Blood samples were collected in a sterile tube containing EDTA. PBMC was separated from blood of HCV infected patients and control groups by density gradient centrifugation. Viral RNA was extracted from plasma and PBMCs by the guanidium isothiocyonate method. The extracted RNA was amplified by RT-PCR method. Anti-HCV ELISA was performed on all samples. Results: About 92.7% of HCV infected patients were undetectable for HCV RNA in plasma and PBMCs samples after treatment. But HCV RNA was detected in plasma and PBMCs samples 6 of 82 (7.3%) patients with chronic HCV after treatment. After antiviral treatment, 146 of 197 (74.2%) patients with thalassaemia were undetectable for HCV RNA and 25.8% (51 of 197) of them had HCV RNA in plasma or PBMCs samples which in two cases, HCV RNA was detected only in PBMC. Conclusion: More than 90 percent of patients had clearance of HCV RNA in both serum and PBMCs after 5 years of response to antiviral treatment while 74.2% of Patients with thalassaemia is achieved to SVR after antiviral therapy. Therefore, the presence of the persistent virus in mononuclear cells of patients may cause hepatitis C virus recurrences at the end of treatment.