Assessment of correlation between serum titers of hepatitis C virus and severity of liver disease.
OBJECTIVE
The significance of hepatitis C virus (HCV) serum titers has been examined in several clinical situations. There is much evidence that patients with a lower viral load have better response rates to anti-viral therapy compared to those with higher levels. Moreover, a direct association has been observed between serum titers of HCV and transmission rates of the virus. The aim of the present study was to determine if there was any correlation between HCV viral load and the severity of liver disease.


METHODS
Fifty patients with HCV infection were included in the study. These comprised of 34 subjects with a history of alcohol use and 16 non-alcoholics. Quantitative serum HCV RNA assay was carried out using the branched DNA (bDNA) technique. Linear regression analysis was performed between serum viral titers and liver tests. In addition, for the purpose of comparison, the subjects were divided into two groups: those with low viral titers (< or = 50 genome mEq/mL) and high titers (> 50 mEq/mL).


RESULTS
All subjects were men, with a mean +/- SD age of 47 +/- 7.8 years. The mean HCV RNA level in the blood was 76.3 x 10(5) +/- 109.1 genome equivalents/mL. There was no correlation between HCV RNA levels and age of the patients (r = 0.181), and the history or amount (g/d) of alcohol consumption (r = 0.07). Furthermore, no correlation was observed between serum HCV RNA levels and the severity of liver disease as judged by the values of serum albumin (r = 0.175), bilirubin (r = 0.217), ALT (r = 0.06) and AST (r = 0.004) levels. Similarly, no significant difference was observed between patients with low viral titers and high titers with respect to any of the parameters.


CONCLUSIONS
Our results indicate that the severity of liver disease is independent of serum levels of hepatitis C virus. These findings are important since they have a direct impact on the current debate regarding the role of direct cytopathic effect of hepatitis C virus versus immune-mediated injury in the pathogenesis of HCV-related liver damage.
Digestive Diseases Section, VA Medical Center, 2002 Holcombe Blvd. Houston, Texas 77030, USA. ana0@flash.net
Bhupinder-S
BS
Anand
Maria
M
Velez
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000428:Alcohol Drinking; D001219:Aspartate Aminotransferases / Q000097:blood; D003937:Diagnosis, Differential; D016679:Genome, Viral; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification*; D006526:Hepatitis C / Q000097:blood* / Q000503:physiopathology; D006801:Humans; D008107:Liver Diseases / Q000097:blood* / Q000503:physiopathology; D008111:Liver Function Tests; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood* / Q000235:genetics; D012044:Regression Analysis; D012720:Severity of Illness Index; D019562:Viral Load
D012367:RNA, Viral; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase