title: Stability of HCV-RNA level and its lack of correlation with disease severity in asymptomatic chronic hepatitis C virus carriers.
abstract: This study examines the relationship between HCV-RNA levels and disease severity in 60 individuals with chronic hepatitis C virus infection. HCV-RNA levels were quantified by the branched DNA (bDNA) assay in 445 samples (median: eight samples per patient) obtained over a median of 40.4 months (95% confidence interval (CI): 37.0-42.5). The median log HCV-RNA level was 6.77 (95% CI: 6.62-6.92) molecular equivalents/mL (MEQ/mL). The median log range of HCV-RNA levels in individual patients over the course of the study was 0.89 (95% CI: 0.69-1.16). HCV-RNA level varied over time by less than one log in 62% of patients, by 1-1.5 logs in 22% and by greater than 1.5 logs in only 17%. Univariate analysis, revealed an inverse association between HCV-RNA levels and ALT levels (P=0.037). Univariate and logistic regression analysis showed no significant association between HCV-RNA levels and either the degree of inflammation or fibrosis. In contrast, there was a significant positive association between alanine aminotransferase (ALT) levels and histological activity especially in individuals with ALTs> 100 IU/L. Hence, HCV-RNA levels: (i) almost always fell within the dynamic range of the bDNA assay; (ii) were stable in asymptomatic chronically infected patients, with only a small proportion of patients exceeding a range of 1.5 logs; (iii) did not correlate with either the extent of inflammation or degree of fibrosis. In contrast, there was a strong association between ALT level and the histological severity of liver disease.
authors.affiliation: Department of Transfusion Medicine, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland 20892, USA.
authors.forename: A E
authors.initials: AE
authors.lastname: Yeo
authors.forename: M
authors.initials: M
authors.lastname: Ghany
authors.forename: C
authors.initials: C
authors.lastname: Conry-Cantilena
authors.forename: J C
authors.initials: JC
authors.lastname: Melpolder
authors.forename: D E
authors.initials: DE
authors.lastname: Kleiner
authors.forename: J W
authors.initials: JW
authors.lastname: Shih
authors.forename: J H
authors.initials: JH
authors.lastname: Hoofnagle
authors.forename: H J
authors.initials: HJ
authors.lastname: Alter
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000378:metabolism; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics* / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000097:blood / Q000503:physiopathology / Q000821:virology*; D006801:Humans; D008099:Liver / Q000201:enzymology / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood / Q000821:virology; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood*; D012044:Regression Analysis
chemical_list: D012367:RNA, Viral; D000410:Alanine Transaminase