Immunological Response and Prevalence of Occult HCV Genotype 4 Among Patients Receiving Direct-Acting Antiviral (DAA) Drugs: A Cross-sectional Study

Background and Objective: Infection with the hepatitis C virus (HCV) is an endemic public health problem with long-term consequences, especially in Egypt. Egypt has one of the highest incidence rates of HCV worldwide. The current cross-sectional study aims to determine how prevalent occult HCV infection is and how it affects the individual's immune response. Methods: The studied adult patients the study had chronic HCV infection and underwent a combination of sofosbuvir 400 mg plus daclatasvir 60 mg once daily ribavirin regimen for 12 weeks from March to September 2019. Quantitative real-time PCR was used to detect HCV-RNA in the plasma. In addition, Cytometric Bead Array (CBA) technique was used to assess cytokines levels. Results: 31 participants from Misr University for Science and Technology University hospitals outpatient clinics were included in the study. The median levels of cytokines of the included patients were as follow: the median IL-6 was 6.56 (5.7- 7.9) pg./mL, and 19% of the patients had higher serum IL-6 levels. None of the patients had abnormal serum levels 28b. in addition, the median serum NF-κB was 232 (18.7- 609.89), and 29% had high serum NF-κB levels. Six (19.4%) patients had positive occult HCV infection. Patients with occult HCV infection exhibited significantly higher values of serum IL-6 (P<0.001), NF-κB P<0.001), serum AST (P<0.001), ALT (P<0.001), albumin (P<0.001), and total bilirubin (P<0.001). Conclusion: We support the evidence about the significant association between occult HCV infection and impaired immunological response in patients who achieved sustained viral response (SVR) following direct-acting antivirals (DAA) regimens.