Sequence Analysis of Hepatitis C Virus From Patients With Relapse After a Sustained Virological Response: Relapse or Reinfection?

摘要: (See the editorial commentary by Tillmann on pages 6–8.) Hepatitis C virus (HCV) infection affects 180 million persons worldwide and at least 3.2 in United States [1, 2]. It is one of main causes progressive liver diseases, such as cirrhosis hepatocellular carcinoma, leading indication for transplantation [3]. Combination therapy pegylated interferon ribavirin successful approximately 50% infected patients, resulting clearance HCV RNA from serum, which accompanied normalization biochemical test results improvement histologic findings [4, 5]. A sustained virological response (SVR) defined absence detectable measured a sensitive reverse-transcription polymerase chain reaction (RT-PCR) 24 weeks after termination treatment [4]. The majority patients who have SVR resolution their disease biochemically histologically. These characteristics led to acceptance an appropriate end point antiviral chronic hepatitis C. Several groups examined durability with [6–10]. maintained almost all associated long-term good prognosis. However, follow up has indicated that relapse infection, detection can occur, although rates stopping therapy) occurred 4.2% [12]. raise issue whether permanent eradication cure opposed suppression viral replication immunological factors. There are few data literature regarding resolved infection. Most reports anecdotal not rigorously explored nature individuals apparent reinfection. unclear these true persistently same strain before or they been reinfected completely novel strain. To address this question, we analyzed sequences specimens 3 whom was redetected serum (by commercial assays) had achieved SVR, compared recovered during late those treatment. In article, referred “patients relapse” because reappeared >6 months it unknown Additionally, extracted biopsy obtained time determine reservoir SVR.