Presence of HCV mixed-genotype infection. Association with HIV coinfection.

BARÉ PATRICIA

Congreso; XXIXth International Congress of the World Federation of Hemophilia; 2010

Before effective virus-inactivation procedures, patients with hemophilia were prone to undergo multiple HCV exposures through non-inactivated factor concentrates. In previous work, HCV variants distinct from the genotypes detected in plasma were detected in peripheral blood mononuclear cells in our population. We investigated now different factors that could be associated to the occurrence of HCV occult genotypes in this reservoir. Cell culture experiments were performed in 25 HCV monoinfected and 25 HIV/HCV coinfected patients at 2 - 3 different time points per patient. Culture supernatants (SN) were analyzed for HCV genome presence and genotyping. Genotypes found in the correspondent plasma samples were compared to those obtained in culture samples. All the coinfected patients and 92% of the monoinfected individuals originated HCV+ cultures. The percentage of HCV+ results in SN ranged from 3 to 79% when considering only cultures from patients without HCV treatment. Sixteen coinfected and 7 monoinfected patients showed occult HCV mixed-genotype infections in their mononuclear cells. The presence of HIV coinfection was found to be associated (p= 0.01) to the possibility of having occult HCV mixed-genotype infections. This association remained positive even after controlling for age, type of hemophilia and percentage of HCV+ culture SN. When considering both groups separately, HCV monoinfected group showed a positive correlation with a severe type of hemophilia that could be directly related to greater HCV exposure (p=0.02). The detection of minor HCV genotypes could be useful, especially in the coinfection setting, to evaluate their contribution to HCV treatment failure.