Abstract

INTRODUCTION: We aimed to evaluate the clinical features and course of patients with anti-HCV positive and HCV RNA negative.

METHODS: This is a retrospective data recording study.Viral markers were requested in patients admitted to Mersin University Hospital Faculty of Medicine, Department of Gastroenterology between the years 2010-2018 and patients with anti-HCV positive and HCV RNA negative were detected. Patients whose HCV RNA was positive atleast once in the period given were separated in a different group. Follow-up results of HCV RNA negative patients were examined. Patients who never received chek up were called for check up. Patients’ demographic characteristics, biochemical tests, viral markers, comorbid diseases and ultrasonography were evaluated.

RESULTS: Anti-HCV was positive in 381 patients. Of these, 238 (62.4%) were HCV RNA positive and 143 (37.5%) were HCV RNA negative. 71 of the HCV RNA negative (49.6%) were male and 72 (50.35%) female. The mean age was 66 and 56 years, respectively. HCV RNA was not positive in the follow-up of patients. Liver enzyme levels were found to be high in 16 (11%) patients. In 12 of these 16 patients (75%), ultrasonography showed a compatible appearance with hepatomegaly and hepatosteatosis, while 4 patients (25%) had a liver disease consistent with liver cirrhosis. When ultrasound findings of all patients with HCV RNA negative were examined, 34 (23.7%) of the patients had borderline irregularity, left lobe hypertrophy and granular increase changes consistent with liver cirrhosis, and 4 (2.8%) of them had hepatocellular carcinoma. Three patients with HCC had Hepatit B infection. When the comorbid diseases of patients with HCV RNA negative were examined it was found out that 13 patients (9%) DM, 15 (10%) HT, 10 (7%) CRF, 4 (2.8%) HBV infection, 3 (2%) breast cancer, 3 (2%) sickle cell anemia, 1 (0.7%) cholangiocellular carcinoma and 1 (0.7%) had colon ca.

CONCLUSION: Anti-HCV positivity is an important finding in patients’ referral to health institutions and in setting public health targets. However, there may not be active infection at this time and HCV RNA may be negative. While this may indicate an improved HCV infection, it might also be an indicator of an ongoing liver disease that causes damage to liver histomorphology during the active infection period. Our study showed that HCV-RNA was negative in 37% of anti-HCV positive patients. Another important finding is; 24% of patients had liver cirrhosis and HCC was detected in some patients. Although hepatosteatosis and HBV infection are among the etiology of cirrhosis, we think that this group should be evaluated and followed more carefully.