TY - JOUR
T1 - Reemergence of hepatitis C virus after 8.5 years in a patient with hypogammaglobulinemia
T2 - Evidence for an occult viral reservoir
AU - Lee, William M.
AU - Polson, Julie E.
AU - Carney, D. Spencer
AU - Sahin, Bogachan
AU - Gale, Michael
N1 - Funding Information:
Received 23 December 2004; accepted 27 April 2005; electronically published 10 August 2005. Potential conflicts of interest: none reported. Financial support: National Institutes of Health (grant AI48235 to M.G.); the Jeanne Roberts and the Rollin W. and Mary Ella King Funds of the Southwestern Medical Foundation, Dallas, Texas (to W.M.L.). Reprints or correspondence: Dr. William M. Lee, Div. of Digestive and Liver Diseases, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9151 (william.lee @utsouthwestern.edu).
PY - 2005/9/15
Y1 - 2005/9/15
N2 - The question of whether viruses persist after apparent clearance of infection remains unanswered. Here, we describe a patient with hypogammaglobulinemia whose acute hepatitis C virus (HCV) infection appeared to resolve after receipt of interferon therapy, relapse immediately, and then clear spontaneously-only to relapse after receipt of corticosteroid therapy, and clear again, 8.5 years later. Sequencing indicated that the viruses detected during each relapse were virtually identical, with the hypervariable region 1 of E2 appearing to be monoclonal, which is typical of patients with hypogammaglobulinemia. Nonstructural 5A sequences exhibited quasispecies diversity initially but, after 8.5 years, had become monoclonal. The prolonged period of negativity for HCV RNA followed by relapse suggests that HCV may persist in apparent sustained viral responders.
AB - The question of whether viruses persist after apparent clearance of infection remains unanswered. Here, we describe a patient with hypogammaglobulinemia whose acute hepatitis C virus (HCV) infection appeared to resolve after receipt of interferon therapy, relapse immediately, and then clear spontaneously-only to relapse after receipt of corticosteroid therapy, and clear again, 8.5 years later. Sequencing indicated that the viruses detected during each relapse were virtually identical, with the hypervariable region 1 of E2 appearing to be monoclonal, which is typical of patients with hypogammaglobulinemia. Nonstructural 5A sequences exhibited quasispecies diversity initially but, after 8.5 years, had become monoclonal. The prolonged period of negativity for HCV RNA followed by relapse suggests that HCV may persist in apparent sustained viral responders.
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U2 - 10.1086/432917
DO - 10.1086/432917
M3 - Article
C2 - 16107964
AN - SCOPUS:24644506127
SN - 0022-1899
VL - 192
SP - 1088
EP - 1092
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 6
ER -