Occult Hepatitis C Virus Infection: Where are We Now?

Abstract

Hepatitis C virus (HCV) is the major cause of chronic liver disease worldwide. Up to 30% of infected individuals spontaneously resolve their acute infection, while others develop chronic hepatitis C and replicate the virus seemingly indefinitely, but the features of the host and virus that are responsible for this difference are not yet clear. The persistence of the virus in the liver can lead to cirrhosis and hepatocellular carcinoma. End-stage liver disease due to a chronic HCV infection is currently the number one reason for liver transplantation in many parts of the world. No prophylactic vaccine is presently available and the current antiviral therapy successfully suppresses HCV replication in fewer than 50% of patients with a chronic infection. Until recently, patients who had eliminated HCV spontaneously or after treatment were considered to be definitively cured. But reports of low HCV RNA concentrations in the plasma, peripheral blood mononuclear cells and livers of patients who had cleared HCV has led to uncertainty in both patients and physicians. This new form of HCV infection is called occult HCV infection. This chapter summarises the data presently available on occult HCV infections and discusses its significance and reality.