Hepatitis C viraemia and liver disease in symptom-free individuals with anti-HCV.
There is controversy about clinical management of patients who persistently have antibodies to hepatitis C virus (anti-HCV) but who have no symptoms and signs of liver disease. We have taken liver biopsy samples from 23 such patients (16 of whom had normal alanine aminotransferase [ALT] values) to assess prevalence of liver disease and to see whether anti-HCV and HCV-RNA correlated with histological findings. 16 patients had histological evidence of chronic hepatitis, which was not predicted by serum ALT or by the pattern of specificity of anti-HCV. All 16 cases with hepatitis C viraemia (HCV-RNA detected by polymerase chain reaction), including 9 with normal ALT, had chronic hepatitis on biopsy (p less than 0.001), whereas 7 HCV-RNA-negative cases had normal liver histology. These findings indicate that serum HCV-RNA is a sensitive and specific marker of liver disease in anti-HCV-positive subjects, independent of ALT values, and challenge the idea of the existence of "true" healthy carriers of HCV.
Second Department of Internal Medicine, University of Padova, Italy.
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Alberti
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Morsica
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L
Chemello
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Cavalletto
F
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Noventa
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Pontisso
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Ruol
D000914:Antibodies, Viral / Q000032:analysis*; D001782:Blood Donors; D002353:Carrier State / Q000276:immunology / Q000382:microbiology*; D002908:Chronic Disease; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016174:Hepacivirus / Q000276:immunology*; D006525:Hepatitis, Viral, Human / Q000276:immunology / Q000382:microbiology*; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis*
D000914:Antibodies, Viral; D012367:RNA, Viral