Hepatitis C virus RNA and hepatitis B virus DNA in serum and liver of patients with fulminant hepatitis.
BACKGROUND
The role of hepatitis C virus (HCV) in the development of fulminant hepatitis is poorly understood.


METHODS
The polymerase chain reaction was used to detect HCV RNA and hepatitis B virus (HBV) DNA in serum and liver of 40 patients with fulminant or subfulminant hepatitis.


RESULTS
HCV RNA was detected in none of the 23 subjects with hepatitis B surface antigen (HBsAg)-negative hepatitis of unknown etiology. HBV DNA was found in 1 of these 23 subjects. In contrast, 8 of the 17 patients with HBsAg-positive hepatitis were HCV RNA positive. Among the latter, 5 had immunoglobulin (Ig) M antibody to hepatitis B core antigen (anti-HBc) and thus were acutely coinfected by HBV and HCV, whereas 3 others without IgM anti-HBc had superinfection by HCV. The active replication of HCV in the liver was shown by detection of high titers of HCV RNA and of negative-stranded HCV RNA.


CONCLUSIONS
This investigation therefore shows no evidence of a role for HCV infection in sporadic cases of fulminant hepatitis without defined etiology. However, it suggests that HCV might be implicated in a significant number of patients with HBV-related fulminant hepatitis.
Institut Pasteur, Paris, France.
C
C
Féray
M
M
Gigou
D
D
Samuel
G
G
Reyes
J
J
Bernuau
M
M
Reynes
H
H
Bismuth
C
C
Bréchot
D000293:Adolescent; D000328:Adult; D001483:Base Sequence; D004279:DNA, Viral / Q000032:analysis* / Q000097:blood; D005260:Female; D016174:Hepacivirus / Q000235:genetics*; D006501:Hepatic Encephalopathy / Q000382:microbiology*; D006505:Hepatitis / Q000382:microbiology*; D006508:Hepatitis Antibodies / Q000032:analysis; D006515:Hepatitis B virus / Q000235:genetics*; D006801:Humans; D008099:Liver / Q000382:microbiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis* / Q000097:blood
D004279:DNA, Viral; D006508:Hepatitis Antibodies; D012367:RNA, Viral