Serum and liver HCV RNA levels in patients with chronic hepatitis C: correlation with clinical and histological features

Abstract

Background: Liver disease in chronic hepatitis C virus (HCV) infection ranges from minimal lesions to liver cirrhosis, eventually evolving to hepatocellular carcinoma. Whether and how HCV determines the different clinical and histological manifestations of the disease is not fully understood.

Aims: To verify whether the amount of virus in individual patients could be related to the severity of liver injury.

Patients and methods: Levels of HCV RNA were measured in serum in 96 consecutive patients with chronic hepatitis type C using a signal amplification assay. The relation between viraemic values and the corresponding viral load in the liver was assessed in a subgroup of 21 patients in whom HCV RNA was measured in serum samples and liver specimens obtained at the same time.

Results: A positive correlation was observed between the amount of viral nucleic acid in the two compartments, indicating that levels of viraemia reflect the amount of virus present in the liver. Viral load did not correlate with aminotransferase activities nor with histological diagnosis, and serum and liver levels of HCV RNA were not significantly different in patients infected by the various HCV genotypes.

Conclusions: Measurement of HCV replication in serum is a mirror of viral replication in the liver. The extent of replicative activity of HCV does not seem to play a role in the modulation of the associated hepatic disease.

Figure 1

Relation between amount of HCV RNA in the liver expressed as Eq/g of tissue and Eq/µg of total cellular RNA.

Figure 2

Viral load detected in serum in anti-HCV positive patients in relation to histological diagnosis.

Figure 3

Viral load in the liver in patients with HCV RNA detectable in the corresponding serum only by PCR and in those with viraemia detectable also by bDNA.