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[TnHepGuy_]

<a href="http://ncrtp-hepc.ca/library.php?id=81">Persistent hepatic alterations in individuals with occult HCV infection following sustained virological response to antiviral therapy</a>

(from the paper):

"<i>Occult HCV infection can be associated with persistent or even progressive liver disease despite normal ALT and stable clinical profile. These individuals should be followed for prolonged period of time after SVR and considered for re-treatment if the disease progresses.</i>"


<a href="http://www.hivandhepatitis.com/2006roberts/hcv/080906_a.html">Compartmentalization of HCV in Plasma and Peripheral Blood Mononuclear Cells</a>


<a href="http://www.blackwell-synergy.com/doi/abs/10.1111/j.1478-3231.2006.01301.x">Antiviral treatment withdrawal in viremic HCV-positive liver transplant patients: impact on viral loads, allograft function and morphology</a>

[beamishboy]

this occult virus persistently Spooks me....if and when patient reaches SVR can we obtain proof of total eradication? maybe a bx 2 yrs after trx ends ,where core samples are examined,stimulated and tested for any lingering virus?? i would like to test All clear at some point-is this feasible?...
Thanks for the post, always welcome your info!

[mikesimon]

My guess is that follow up biopsies would be more than needed as long as liver enzymes stay at normal levels. I think annual blood tests including a liver profile would be a prudent approach for SVRs just to be sure there is nothing going on. I read that despite normal ALT there was some disease progression but I am a bit skeptical about this conclusion and would need to see a larger sampling size and a more detailed look at blood test results before embracing the advisability of follow up biopsies. That's just my opinion but I'd feel safe with normal liver enzymes and wouldn't consent to biopsy unless my surgeon pushed it or I see more evidence that indicates the value. Mike

[mikesimon]

From: http://www.bioreclamation.com/subcat/pbmc_ext.html

Peripheral blood mononuclear cells (PBMC's) refers to blood cells having a round shaped nucleus (i.e. lymphocytes and Monocytes). Physiologically, these cells are critical components of the defense mechanism against infection.

    PBMC can be isolated from whole blood samples using different density gradient centrifugation procedures. Anticoagulated whole blood is layered over the separating medium. At the end of the centrifugation step, the following layers are visually observed from top to bottom: plasma/platelets, PBMC, separating medium and erythrocytes / granulocytes. The PBMC layer is then removed and washed to get rid of some contaminants before cell type and cell viability can be confirmed.

PBMC extraction procedures have many different applications such as:
  

[cuteus]

i had read that article on compartmentalization before and found it intriguing.  I always wondered how you test PBMC? is it a regular blood test?  what is termed as whole blood test?

[cuteus]

that compartmentalization article was reprinted strangely, repeating itself a bit?
I never thought I would be happy to have been geno 1:
'Compartmentalization was less frequent among patients with genotype 1 HCV in their plasma (26/73, 24% vs 28/40, 65%; P < 0.01).'
I wonder why it does not break the results down by subjects on tx (65) and the non treating?

[mikesimon]

Thanks TnHepGuy for the links. I don't see anything really new here but, for those unfamiliar with "occult" and/or "persistent" HCV, it should be enlightening. What I never see is analysis of serum collected with tissue sample which is, of course, a subject that very much itrigues me. Thanks again, Mike