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Viral load and clinicopathological features of chronic hepatitis C (1b) in a homogeneous patient population
L Fanning1, E Kenny, M Sheehan
1Department of Medicine, National University of Ireland, Cork, University College Cork, Ireland. L.FANNING@UCCE.IE
Insights
Quantitative viral load monitoring in hepatitis C virus (HCV) infection showed a weak correlation with liver inflammation but not fibrosis or ALT levels in a homogenous patient group.
Area of Science:
- Hepatology
- Virology
- Clinical Biochemistry
Background:
- Hepatitis C virus (HCV) progression monitoring traditionally relies on clinical, biochemical, and histological markers.
- Quantitative viral load measurement via reverse-transcription polymerase chain reaction (RT-PCR) is proposed as a more reliable disease marker.
- Previous studies reported conflicting viral titer data due to patient heterogeneity.
Purpose of the Study:
- To correlate quantitative serum viral load with alanine transaminase (ALT) levels and histological findings.
- To investigate these correlations within a homogenous population to minimize confounding factors.
Main Methods:
- Study involved 77 Rhesus-negative women with chronic hepatitis C type 1b, uniformly infected and untreated.
- Liver biopsies were assessed by a single, blinded histopathologist for inflammation and fibrosis.
- Serum viral load and ALT levels were quantified and correlated with histological data.
Main Results:
- A weak but significant correlation was observed between serum viral load and the degree of liver inflammation (rs =.26; P <.05).
- No significant correlation was found between serum viral load and the degree of liver fibrosis (P =.06).
- Serum viral load did not correlate significantly with ALT levels, though ALT correlated with inflammation (rs =.241; P =.035).
Conclusions:
- Quantitative serum viral load has a limited correlation with liver inflammation and no significant correlation with fibrosis or ALT in this specific HCV patient cohort.
- These findings highlight the complexity of HCV disease progression markers and the importance of homogenous study populations.
Abstract:
Monitoring the progression of hepatitis C virus (HCV) includes clinical, biochemical, and histological parameters. Quantitation of viral load by reverse-transcription polymerase chain reaction (RT-PCR) may offer a more reliable marker of disease status. Conflicting reports on viral titers may reflect heterogeneity of patient population, mode of infection, and viral type/subtype. The aim of this study was to correlate quantitative serum viral load with alanine transaminase (ALT) and histological status in a homogenous population. The study population consisted of 77 Rhesus-negative women with chronic hepatitis C type 1b. Homogenous features of this study population included: same defined source of infection (contaminated anti-D immunoglobulin); same duration of disease (17 years at the time of study); same viral type/subtype; same ethnic origin; all healthy child-bearing females at the time of infection; and an absence of competing risk factors for infectious and other liver diseases. None of the patients had received antiviral treatment at the time of study. Liver biopsy was performed on all patients. All biopsies were scored by a single histopathologist who was blinded to the clinical and viral status of each patient. A weak, but statistically significant, correlation (rs =.26; P <.05) between serum viral load and the degree of inflammation (mean value: 3.87 +/- 2.17 [SD]) was found. There was no significant correlation between serum viral load and the degree of fibrosis (mean value: 0.84 +/- 0.8 [SD]; P =.06). There was no significant correlation between serum viral load and ALT, although there was a correlation between ALT and the degree of inflammation (rs =.241; P =.035).