Platelets as an Extra-Hepatic Reservoir of Hepatitis C Virus RNA: A Prospective Study

Introduction: In the era of Direct Acting Antiviral (DAA), elimination of HCV is possible but persistence in extra hepatic sites is hindrance. Detection of HCV has been reported in platelets, however its impact on DAA therapy not been studied. Aim: Detection and quantification of HCV RNA from the platelets and to compare with parallel plasma levels. Materials and Methods: Whole blood collected from 62 chronic HCV infected patients. HCV RNA quantitation was done from paired plasma and platelet pool at baseline using commercial real time PCR assay (Abbott). Correlation calculated by Bland-Altman analysis. Bivariate association and p-value calculated using chi-square tests. Results: A total of 45 patients were viremic while 17 were nonviremic. Median plasma viral load was log105.7 (IQR: log103.55- 6.7) IU/mL, median platelet viral load was log104.13 (IQR: log100- 5.5) IU/mL. Genotype (GT) 3 (66.6%) was commonest followed by GT 1 (33.3%). Sustained Virologic Response (SVR) was attained in 39/45 patients (92.8%) patients while 3/45 patients (6.67%) were non-responders. Viral load at baseline in platelet pool was higher in non-responders when compared to those achieved SVR (median log104.46 vs. log103.27, p=0.456). Conclusion: HCV-RNA was efficiently detected in platelets. Persistence in platelets could be one of the factors associated with treatment failure.