Related Experiment Video
Updated: Jul 30, 2026
A Protocol for Analyzing Hepatitis C Virus Replication
Published on: June 26, 2014
Tissue viral load variability in chronic hepatitis C
L Fanning1, J Loane, E Kenny-Walsh
1Department of Medicine, Cork University Hospital, National University of Ireland.
Insights
Viral load in liver biopsies shows consistent results between lobes, unlike histology. This suggests hepatic viral load assessment is more reliable than histological analysis in chronic hepatitis C patients.
Area of Science:
- Hepatology
- Virology
- Medical Diagnostics
Background:
- Liver biopsy is the standard for assessing chronic hepatitis C (HCV) disease activity.
- Sampling variability in liver biopsies can limit histological assessment accuracy.
- Uncertainty exists regarding whether viral load assessment is subject to similar sampling variability.
Purpose of the Study:
- To compare viral load and histological assessment between right and left liver lobe biopsy specimens in HCV-infected patients.
- To determine if sampling variability affects hepatic viral load measurements similarly to histology.
Main Methods:
- Bilateral liver biopsies were performed on 16 HCV RNA-positive patients.
- HCV genotype, histology, and hepatic viral load were assessed blindly.
- Patients had no other liver diseases or competing risk factors and were treatment-naïve.
Main Results:
- Hepatitis C virus (HCV) detection was concordant between lobes and serum.
- Hepatic viral load demonstrated high correlation between right and left lobes (r=0.79, p=0.0003).
- Histological indices for inflammation (r=0.60, p=0.038) and fibrosis/cirrhosis (r=0.50, p=0.098) showed poor correlation between lobes.
Conclusions:
- Hepatic viral load assessment in chronic hepatitis C exhibits significantly less sampling variability compared to histological evaluation.
- Viral load measurements from different liver lobes are more consistent than histological findings.
- This suggests hepatic viral load is a more reliable marker of disease activity in HCV due to lower sampling heterogeneity.
Objective:
Liver biopsy is regarded as the gold standard for assessing disease activity in chronic hepatitis C, but sampling error is a potential limitation. Whether sampling variability applies equally to viral load assessment as it does to histology is uncertain. To examine this, we compared viral load between right- and left-lobe biopsy specimens from patients infected with hepatitis C virus (HCV).
Methods:
Bilobe biopsies were taken from 16 patients who were serum positive for HCV RNA by reverse transcription-polymerase chain reaction. Genotype was identified by reverse line probe hybridization. There was an absence of competing risk factors for infectious and other liver diseases in this patient group. Histology and hepatic viral load were assessed blindly. None of the patients had received antiviral therapy at the time of study.
Results:
Detection of HCV in right and left lobes was concordant with serum positivity in all cases. The viral load between lobes was highly correlated (p = 0.0003, r = 0.79). In contrast, the histological activity indices of inflammation and fibrosis/cirrhosis were poorly correlated between lobes (p = 0.038, r = 0.60, and p = 0.098, r = 0.50, respectively).
Conclusion:
Hepatic viral load variability does not suffer from the same degree of heterogeneity of sampling variability as does histology.
Related Concept Videos
01:25Hepatitis
01:28Viral Hepatitis I: Introduction