title: Role of hepatic HCV-RNA level on the severity of chronic hepatitis C and response to antiviral therapy.
abstract: BACKGROUND
  Correlation between hepatic HCV-RNA and serum HCV-RNA, severity of liver disease and response to therapy is poorly known.
  
  
  OBJECTIVE
  To assess the influence of hepatic HCV-RNA level on severity of liver disease and response to therapy in a large cohort of chronic hepatitis C (CHC) patients.
  
  
  METHODS
  HCV-RNA was measured in frozen liver biopsies and serum samples from 130 CHC patients the day of liver biopsy prior to treatment. Liver fibrosis was assessed by Ishaq scoring. A Sustained Virological Response (SVR) was observed in 52% of the patients, non-response (NR) in 34%.
  
  
  RESULTS
  Mean±standard deviation hepatic HCV-RNA level was 7.69±0.67 log(10) copies/mg of liver. Mean serum HCV-RNA level was 6.21±0.72 log(10) copies/ml. There was a correlation between hepatic and serum HCV-RNA in genotype 1 and 4 (p=0.008 and p=0.03) and age (p=0.006). Mean hepatic HCV-RNA was 7.70±0.69 vs 7.67±0.68 log(10) copies/mg of liver, in patients with significant fibrosis vs those with mild fibrosis, respectively (p=0.7); 8.04±0.68; 7.44±0.47; 7.43±0.49 and 7.44±0.71 log(10) copies/mg of liver in genotypes 1, 2, 3 and 4, respectively (p=0.0001); higher in women than in men (p=0.04); 7.60±0.63, 7.71±0.54 and 7.96±0.73 log(10) copies/mg in SVR, relapsers and NR, respectively (p=0.1). Multivariate analysis showed that high hepatic HCV-RNA level was independently associated with genotype and response to therapy was associated with genotype independently from hepatic HCV-RNA level.
  
  
  CONCLUSIONS
  Hepatic HCV-RNA level was not associated with severity of liver disease. High level was strongly associated with HCV genotype independently from response to therapy.
authors.affiliation: Service de Microbiologie, Université Paris VII, Faculté de Médecine Denis Diderot, Hôpital Bichat, Paris, France.
authors.forename: Sarah
authors.initials: S
authors.lastname: Maylin
authors.forename: Cédric
authors.initials: C
authors.lastname: Laouénan
authors.forename: Michelle
authors.initials: M
authors.lastname: Martinot-Peignoux
authors.forename: Xavière
authors.initials: X
authors.lastname: Panhard
authors.forename: Martine
authors.initials: M
authors.lastname: Lapalus
authors.forename: Marie Hélène
authors.initials: MH
authors.lastname: Nicolas-Chanoine
authors.forename: Pierre
authors.initials: P
authors.lastname: Bedossa
authors.forename: Tarik
authors.initials: T
authors.lastname: Asselah
authors.forename: Patrick
authors.initials: P
authors.lastname: Marcellin
mesh_terms: D000328:Adult; D001706:Biopsy; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics* / Q000302:isolation & purification / Q000472:pathogenicity; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D008099:Liver / Q000473:pathology / Q000821:virology*; D008103:Liver Cirrhosis / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012367:RNA, Viral / Q000032:analysis / Q000097:blood*; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D016898:Interferon-alpha; D012367:RNA, Viral; D012254:Ribavirin