Hepatitis C viral load does not predict disease outcome: going beyond numbers.
The analysis of 58 patients with chronic hepatitis C without cirrhosis and treated with interferon-alpha demonstrated that hepatitis C viral (HCV) load does not correlate with the histological evolution of the disease (p = 0.6559 for architectural alterations and p = 0.6271 for the histological activity index). Therefore, the use of viral RNA quantification as an evolutive predictor or determinant of the severity of hepatitis C is incorrect and of relative value. A review of the literature provided fundamental and interdependent HCV (genotype, heterogeneity and mutants, specific proteins), host (sex, age, weight, etc) and treatment variables (dosage, time of treatment, type of interferon) within the broader context of viral kinetics, interferon-mediated immunological response (in addition to natural immunity against HCV) and the role of interferon as a modulator of fibrogenesis. Therefore, viral load implies much more than numbers and the correct interpretation of these data should consider a broader context depending on multiple factors that are more complex than the simple value obtained upon quantification.
de Araujo
Evaldo Stanislau Affonso
ES
Departamento de Moléstias Infecciosas e Parasitárias, FMUSP, São Paulo, SP, Brasil.
Cavalheiro
Norma de Paula
Nde P
Cubero Leitao
Regina Maria
RM
Borges Tosta
Rose Aparecida
RA
Barone
Antonio Alci
AA
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D006521:Hepatitis, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D012367:RNA, Viral / Q000032:analysis; D019562:Viral Load
D000998:Antiviral Agents; D016898:Interferon-alpha; D012367:RNA, Viral