Comparative analysis of viral titers and histologic features of Pakistani patients infected with hepatitis C virus type 3.
BACKGROUND
Serum hepatitis C virus (HCV) RNA levels and genotypes are considered to be important determinants of the response to interferon treatment. Generally, patterns of viral loads have been reported for HCV type 1 infections and categorized as low- or high-level viremia. We studied the distribution of HCV RNA levels in patients predominantly infected with HCV type 3 and correlated it with hepatic damage.


METHODS
Serum HCV RNA levels and HCV serotypes were determined in 245 anti-HCV-positive patients representing all the major ethnic groups of Pakistan. Patients were grouped according to their HCV RNA levels as: level I (up to 50th percentile); level II (50th to 75th percentile); and level III (>75th percentile).


RESULTS
Sixty-one patients (25%) had high-level viremia (level III) of 13.9 mega equivalent per milliliter (MEq/mL) or greater. These were more likely to be males (48 versus 13, P<0.05). A higher viral load correlated with advanced levels of fatty changes in liver. HCV type 3 was found in 68% of the samples, and type 1 in 14%; the rest were undefined. Mean HCV RNA levels were lower in patients infected with HCV type 3 than in patients infected with HCV type 1 (8.63 MEq/mL versus 37 MEq/mL; P<0.001).


CONCLUSIONS
Most patients with HCV type 3 infection had viremia that was significantly lower than that in HCV type 1-infected patients. This may be the reason for the better response to treatment usually seen in such cases. The severity of histologic changes was not associated with HCV type 3 viremia levels.
Moatter
Tariq
T
Department of Pathology, The Aga Khan University, Karachi, Pakistan. moattert@akunet.org
Hussainy
Akbar Shah
AS
Hamid
Saeed
S
Ahmad
Zubair
Z
Siddiqui
Shahid
S
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000235:genetics / Q000502:physiology*; D006526:Hepatitis C / Q000473:pathology* / Q000821:virology; D006801:Humans; D008099:Liver / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D012367:RNA, Viral / Q000097:blood*; D012703:Serotyping; D012720:Severity of Illness Index; D019562:Viral Load; D014766:Viremia / Q000821:virology
D012367:RNA, Viral