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The epidemiologic significance and clinical pattern of HCV induced chronic hepatitis in India
S K Nanda1, S K Panda, S Jameel
1Department of Pathology and Gastroenterology, All India Institute of Medical Sciences, New Delhi.
Insights
Hepatitis C virus (HCV) RNA was detected in 75% of non-B chronic hepatitis patients. This study links HCV infection to severe liver disease, highlighting the need for improved diagnostic tests.
Area of Science:
- Hepatology
- Virology
- Molecular Biology
Background:
- Chronic hepatitis is a significant liver disease.
- Hepatitis B virus (HBV) is a common cause of chronic hepatitis.
- Hepatitis C virus (HCV) is an emerging cause of chronic liver disease.
Purpose of the Study:
- To determine the prevalence of HCV RNA in patients with non-B chronic hepatitis.
- To investigate the association between HCV infection and severe liver disease.
- To evaluate the utility of antibody assays and RT-PCR for HCV diagnosis.
Main Methods:
- Patients with biopsy-proven chronic hepatitis were screened.
- Hepatitis B virus infection was excluded in the study group.
- Hepatitis C virus RNA was detected using reverse transcription polymerase chain reaction (RT-PCR).
- Antibody to HCV (anti-HCV) was also tested.
Main Results:
- HCV RNA was detected in 12 out of 16 (75%) patients with non-B chronic hepatitis.
- All seven patients positive for anti-HCV were also positive for HCV RNA.
- Two patients had a history of blood transfusion, and two presented with severe acute liver disease.
- HCV infection was associated with severe liver disease.
Conclusions:
- HCV is a significant cause of chronic hepatitis, particularly in non-B cases.
- RT-PCR is a sensitive method for detecting HCV RNA, even when antibody assays are limited.
- Further development of diagnostic tests for local HCV strains is warranted.
Abstract:
Hepatitis C virus (HCV) ribonucleic acid (RNA) was tested for in a group of 16 defined non-B chronic hepatitis patients using specific reverse transcription polymerase chain reaction (RT-PCR). These were chosen from amongst 56 biopsy proven cases of chronic hepatitis of which majority (40) were positive for hepatitis B virus infection. Hepatitis C virus RNA could be demonstrated in 12 (75%) of remaining 16 cases. These include all seven patients positive for antibody to HCV. Two of these patients had past history of blood transfusion and in another two the clinical course started with severe acute liver disease. This study establishes the association of HCV with severe liver disease. The clinical and biochemical profiles are also discussed. In view of limited sensitivity of the antibody assays it is justified to develop diagnostic testes based on local strains.