A New Twist to a Chronic HCV Infection: Occult Hepatitis C
Table 1
Characteristics of occult hepatitis C infection (OCI)+.
Secondary OCI
Cryptogenic OCI
Evidence of liver injury
ALT elevated
No
Yes
Histological lesions
Inflammatory: minimal to mod.
Occasional
Frequent
Fibrotic: minimal to severe
Frequent
Frequent
Organs involved
Liver
Yes
Yes
Lymphatic system (PBMC)
Yes
Yes
Anti-HCV detection
Positive
Negative
HCV-RNA detection
Serum
Yes
Yes
PBMC
Yes
Yes
Liver
Yes
Yes
Longevity of persistence
At least 9 years
Unknown
Secondary OCI: residual infection continuing after spontaneous resolution or after achieving apparent SVR following HCV therapy. Antibodies against HCV can be detected in up to 40% in cryptogenic OCI. +Adopted from Pham et al. [19], Liver International, 2010; 502-11.