Intrahepatic hepatitis C virus replication is increased in patients with regular alcohol consumption.
OBJECTIVE
To assess clinical significance of liver hepatitis C virus RNA levels and their relationship with epidemiological, biochemical and histological factors.


METHODS
A total of 50 patients (mean age 35.5+/-7 years) with biopsy-proven chronic hepatitis C infection were recruited. Risk factors were drug abuse (n=21), transfusion (n=16), other parental routes (n=8; surgery=3, tattooing=5), and idiopathic (n=5). Duration of infection was 16+/-9 years. All patients showed abnormal alanine aminotransferase levels and positive serum hepatitis C virus RNA. Hepatitis C virus genotype was assessed by Inno-Lipa. Liver biopsy was performed for histology and for hepatitis C virus RNA quantification by Amplicor-HCV-Monitor Daily alcohol consumption was recorded on two occasions by anamnesis. Inflammation grade was mild (n=31) or severe (n=19). Fibrosis was early stage (n=42) or advanced (n=8).


RESULTS
Mean hepatitis C virus RNA levels were 9.4x10(5)+/-1.5x10(6) copies/microg of total RNA in liver tissue, and 9.1x10(5)+/-1.3x10(6) copies/ml in serum. Viral load in liver was positively correlated with that in serum (r=0.51, p<0.001) and there was a significant relationship between daily alcohol consumption and intrahepatic hepatitis C virus burden (r=0.53; p<0.001). Patients infected with genotype 3a showed lower intrahepatic hepatitis C virus load than patients infected with genotype 1b; albeit without reaching statistical significance (0.49x10(6)+/-0.89x10(6) vs 1.44x10(6)+/-1.9x10(6) copies/microg of total RNA; p=NS). No relationships were observed between liver viral burden and age, risk factor status, duration of infection, ferritin and alanine aminotransferase levels or with grading and staging.


CONCLUSIONS
Hepatitis C virus load in serum is a mirror of intrahepatic hepatitis C virus levels. Chronic alcohol consumption enhances intrahepatic hepatitis C virus concentration.
Romero-Gómez
M
M
Units of Hepatology, Hospital Universitario de Valme, Seville, Spain. mromerog@meditex.es
Grande
L
L
Nogales
M C
MC
Fernández
M
M
Chavez
M
M
Castro
M
M
D000328:Adult; D000428:Alcohol Drinking; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics* / Q000502:physiology; D006801:Humans; D008099:Liver / Q000821:virology*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood*; D014779:Virus Replication
D012367:RNA, Viral