Peripheral blood monocytes in prediction of response to direct acting antiviral drugs in chronic HCV patients

Abstract

Background:  Eradication rate of hepatitis C virus (HCV) infection had dramatically increased in era of direct acting antivirals (DAAs). However, predicting relapse post-treatment had to be more speculated. Aim: to evaluate role of peripheral blood monocytes (PBMCs) HCV PCR as predictor of post-treatment relapse. Methods: For chronic HCV patients who achieved end of treatment response, HCV PCR at PBMNs was assessed in relation to SVR. Results: 112 out of 118 cases had SVR 24 with only six relapsers (5.1%). Negativity of triple HCV RNA was significantly lower in relapsers than in patients who achieved SVR (16.7% versus 92.9%, p= 0.001). Cases with two positive strands were relapsers (n= 2,33.3%). Single RNA positive strand was detected in 50% of relapsers (n=3) and in 8 out of 112 (7.1%) of patients who achieved SVR. Significant factors affecting treatment response were absence of esophageal varices, negativity of triple HCV RNA, albumin, platelets, INR, creatinine and MELD score. On multivariate analysis, negativity of triple HCV RNA was significant predictor of achieving SVR with 208.38 Odds Ratio and 95% CI (4.93-8809.97, p= 0.005). Conclusion: Relying on presence of HCV on PBMCs at end of treatment with DAAs might be a trustworthy independent predictor of relapse.