Hepatitis C virus (HCV) has been found to infect peripheral blood mononuclear cells (PBMCs), using them as a reservoir, which might contribute to development of resistance to treatment. The study evaluated the predictive value of existence of HCV RNA in PBMCs of chronic hepatitis C patients and its association with HCV seroconversion following the completion of therapy with direct antiviral agents (DAAs). Methods: 58 Egyptian patients were included with chronic HCV infection
who achieved negative serum HCV RNA after completion of therapy with DAAs. HCV RNA in PBMCs and serum was investigated at the end of treatment and 12 weeks later. At the end of treatment patients were subdivided into three groups. GA: included 23 patients with negative (positive & negative strands of HCV RNA) in PBMCs. GB: included 24 patients with positive (positive strand) of HCV RNA in PBMNCs. GC: included 11 patients with positive (positive &
negative strands of HCV RNA) in PBMCs. The results showed that 16 relapsers out of 58 patients (27.59 %). GA only one patient out of 23 (4.3 %) failed to achieve SVR, so the absence of HCV RNA in PBMNCs is associated with high SVR rate (95.7%).GB 10/24 patients failed to achieve SVR, so the presence of HCV RNA positive strand in PBMNCs is associated with high relapse rate (41.7 %), GC 5/11 patients failed to achieve SVR, where the presence of HCV RNA (negative replicative and positive genomic strands) in PBMNCs is associated with higher rate of relapse (45.45%).