title: Detection of high biliary and fecal viral loads in patients with chronic hepatitis C virus infection.
abstract: BACKGROUND
  The life cycle of the hepatitis C virus (HCV) is closely associated with lipid metabolism. Recently, NPC1L1 (a cholesterol transporter) has been reported to function as an HCV receptor. This receptor is expressed in the hepatocyte canalicular membrane and in the intestine; serving as a key transporter for the cholesterol enterohepatic cycle.
  
  
  OBJECTIVE
  We hypothesized that HCV might have a similar cycle, so we aimed to study the presence of HCV in bile and stools of infected patients.
  
  
  METHODS
  Blood, feces, and duodenal bile samples were collected from patients infected with HCV. The biliary viral load was normalized to the bile salt concentration of each sample and the presence of HCV core protein was also evaluated. A total of 12 patients were recruited. HCV RNA was detected in the bile from ten patients.
  
  
  RESULTS
  The mean viral load was 2.5log10IU/60mg bile salt. In the stool samples, HCV RNA was detected in ten patients (mean concentration 2.7log10IU/g of feces).
  
  
  CONCLUSIONS
  HCV RNA is readily detectable and is present at relatively high concentrations in the bile and stool samples of infected patients. This may be relevant as a source of infection in men who have sex with men. Biliary HCV secretion may perhaps play a role in the persistence of viral infection via an enterohepatic cycle of the virus or intrahepatic spread.
authors.affiliation: Department of Gastroenterology, Pontificia Universidad Católica de Chile, Chile.
authors.forename: Hugo
authors.initials: H
authors.lastname: Monrroy
authors.affiliation: Laboratorio de Virología Molecular, Instituto Milenio de Inmunología e Inmunoterapia, Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile.
authors.forename: Jenniffer
authors.initials: J
authors.lastname: Angulo
authors.affiliation: Laboratorio de Virología Molecular, Instituto Milenio de Inmunología e Inmunoterapia, Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile.
authors.forename: Karla
authors.initials: K
authors.lastname: Pino
authors.affiliation: Department of Gastroenterology, Pontificia Universidad Católica de Chile, Chile.
authors.forename: Pilar
authors.initials: P
authors.lastname: Labbé
authors.affiliation: Department of Gastroenterology, Pontificia Universidad Católica de Chile, Chile.
authors.forename: Juan Francisco
authors.initials: JF
authors.lastname: Miquel
authors.affiliation: Laboratorio de Virología Molecular, Instituto Milenio de Inmunología e Inmunoterapia, Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile.
authors.forename: Marcelo
authors.initials: M
authors.lastname: López-Lastra
authors.affiliation: Department of Gastroenterology, Pontificia Universidad Católica de Chile, Chile. Electronic address: asoza@med.puc.cl.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Soza
mesh_terms: D001646:Bile / Q000821:virology*; D002677:Chile; D002784:Cholesterol / Q000097:blood; D004386:Duodenum; D020895:Enterocytes / Q000378:metabolism / Q000821:virology; D004764:Enterohepatic Circulation; D005243:Feces / Q000821:virology*; D016174:Hepacivirus / Q000254:growth & development / Q000302:isolation & purification*; D019698:Hepatitis C, Chronic / Q000378:metabolism / Q000821:virology*; D022781:Hepatocytes / Q000378:metabolism / Q000821:virology; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism; D007422:Intestines / Q000821:virology; D008018:Life Cycle Stages; D050356:Lipid Metabolism; D008565:Membrane Proteins / Q000502:physiology; D026901:Membrane Transport Proteins; D012367:RNA, Viral / Q000032:analysis; D011991:Receptors, Virus / Q000502:physiology; D014280:Triglycerides / Q000097:blood; D019562:Viral Load; D017201:Virus Shedding
chemical_list: D008565:Membrane Proteins; D026901:Membrane Transport Proteins; C410800:NPC1L1 protein, human; D012367:RNA, Viral; D011991:Receptors, Virus; D014280:Triglycerides; D002784:Cholesterol
keywords: Bile; Bilis; Cholesterol; Colesterol; Enterohepatic; Enterohepática; Feces; Gut; Heces; Hepatitis C virus; Intestino; Virus de la hepatitis C