Posted: 8-Nov-2006 << BACK
NEW YORK Reuters Health - 8th November 2006
Hepatitis C virus (HCV) can persist and replicate in the livers of patients who have apparently cleared the virus from their blood after antiviral therapy, a study suggests.
Previous studies have identified HCV in liver tissue of patients with a sustained response to anti-HCV treatment. However, it was unclear if viable HCV, capable of replication, was actually present.
In the present study, Dr. Vicente Carreno and colleagues, from the Foundation for the Study of Viral Hepatitis in Madrid, Spain, tested HCV in hepatic tissue taken from 20 patients who had shown no evidence of the virus in blood for 35.4 months on average.
Nineteen of the 20 samples contained "positive-strand" HCV RNA, the report indicates. Moreover, of these 19 samples, 15 also had "negative-strand" HCV RNA, which is capable of replicating.
Testing of peripheral blood mononuclear cells revealed positive-strand HCV RNA in 13 of 20 samples. Twelve of the 13 samples also contained the all-important negative-strand HCV RNA.
The post-treatment liver biopsy specimens of 15 patients still displayed signs of liver damage. However, hepatic damage improved in all but two of the patients.
Liver necroinflammation was still present in the posttreatment liver biopsy specimens of 15 patients, and fibrosis was present in 7, although liver damage improved in all but 2 patients.
The findings indicate that "these patients did not experience HCV infection clearance, despite apparent clinical disease resolution," the researchers conclude.
They say the possibility of HCV reactivation should be borne in mind if patients undergo chemotherapy or become immunosuppressed, for example. The team cites a case in which HCV reemerged following prednisone therapy, after 8.5 years of negative test results. SOURCE: Clinical Infectious Diseases, November 15, 2006.
Prednisone is a synthetic corticosteroid. Prednisone is a prodrug that is converted by the liver into prednisolone, which is the active drug and a steroid. Prednisone is particularly effective as an immunosuppressant and affects virtually all of the immune system. It can therefore be used in autoimmune diseases, inflammatory diseases (such as severe asthma, severe poison ivy, and Crohn's disease), various kidney diseases including nephrotic syndrome, and to prevent and treat rejection in organ transplantation.
