Detection of HCV RNA and NS5A protein in peripheral blood mononuclear cells after sustained virological response may cause viral relapse

Chronic hepatitis c infection is the main causative agents for public health problem. hepatitis c virus (hcv) is generally considered as hepatotropic virus but it can also infect the peripheral blood mononuclear cells (pbmcs). the aim of present study was to detect hcv rna and non-structural protein 5 (ns5a) in pbmcs of the patients who achieved sustained virological response (svr) and to explore their role in relapse. we investigated hcv rna of genotype 3a in pbmcs of svr responders pakistani patients. a total of 62 patients who achieved svr treated with interferon and ribavirin for 24 weeks were included in the study. pbmcs from blood were isolated by ficoll gradient centrifugation method using ficoll reagent. viral rna in pbmcs was detected by quantitative real time pcr and hcv ns5a protein in was detected by immunofluorescence assay. seven (11.3%) patients were relapsers. a positive association between viral rna in the pbmcs and relapse was observed. relapse occurred significantly more often in patients with hcv rna in their pbmcs at svr stage than the patients who did not have the rna (25 % vs 4.8 %,p=0.03 or=6.66 ci%=1.16-38.13). hcv protein expression in pbmcs have showed the significant association with relapse (31.6% vs 2.3%,or=19.39; p=0.00). the study concludes that patients having hcv rna and ns5a protein in pbmcs after achieving the svr are more likely to go in relapse as compared to those negative for hcv rna and protein in pbmcs. copyright 2015 zoological society of pakistan.