Related Experiment Videos
Hepatitis C viremia in chronic liver disease: relationship to interferon-alpha or corticosteroid treatment
Insights
Hepatitis C virus (HCV) RNA levels were detected in most patients with chronic liver disease. Viremia was highest in chronic hepatitis and decreased with cirrhosis and hepatocellular carcinoma, but increased with prednisone treatment.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Chronic liver disease encompasses conditions like chronic hepatitis, cirrhosis, and hepatocellular carcinoma.
- Hepatitis C virus (HCV) is a significant cause of chronic liver disease globally.
- Understanding hepatitis C viremia patterns is crucial for disease management and treatment efficacy.
Purpose of the Study:
- To assess the pattern of hepatitis C viremia in patients with chronic liver disease.
- To compare viremia levels across different stages of liver disease (chronic hepatitis, cirrhosis, hepatocellular carcinoma).
- To investigate the relationship between viremia and response to interferon-alpha and prednisone treatments.
Main Methods:
- Studied 100 hepatitis C virus antibody-positive patients with varying chronic liver disease.
- Detected and quantified serum hepatitis C virus RNA using nested polymerase chain reaction (PCR) and branched DNA (bDNA) assays.
- Retrospectively analyzed viremia in patients treated with interferon-alpha and prednisone.
Main Results:
- Hepatitis C virus RNA was detected in 94% of patients by PCR and 71% by bDNA.
- Mean viremia was highest in chronic hepatitis (5,700 x 10^3 eq/ml), decreasing in cirrhosis (3,340 x 10^3 eq/ml) and hepatocellular carcinoma (1,768 x 10^3 eq/ml).
- Viremia was similar in interferon responders and non-responders but lower in those maintaining remission; prednisone treatment increased viremia.
Conclusions:
- Hepatitis C viremia patterns vary across chronic liver disease stages, generally decreasing with disease progression.
- Interferon-alpha treatment outcomes correlate with sustained lower viremia post-treatment.
- Prednisone treatment may increase hepatitis C viremia, warranting careful consideration in patients with autoantibodies.
Abstract:
We assessed the pattern of hepatitis C viremia in chronic liver disease by studying 100 hepatitis C virus antibody-positive patients: 48 with chronic hepatitis, 21 with cirrhosis and 31 with hepatocellular carcinoma and cirrhosis. Serum hepatitis C virus RNA was detected by means of both the conventional nested polymerase chain reaction and a newly developed assay based on branched DNA that can also quantify viremia. Hepatitis C virus RNA was found in 94 of 100 patients with polymerase chain reaction and in 71 of 100 patients with branched-DNA (p < 0.001). Mean viremia level (x 10(3) genome equivalents/ml +/- S.D.), as assessed with the branched-DNA test, was 5,700 +/- 7,618 in the 48 patients with chronic hepatitis, 3,340 +/- 3,633 in the 21 patients with cirrhosis and 1,768 +/- 2,770 in the 31 patients with hepatocellular carcinoma (p < 0.02). We also analyzed retrospectively the relationship between viremia and treatment. Fifty-five patients (41 chronic hepatitis, 14 cirrhosis) underwent interferon-alpha treatment. Mean viremia level was comparable among the 30 responders (5,644 +/- 8,207) and the 25 nonresponders (5,519 +/- 6,208) to interferon, but it was significantly lower (1,841 +/- 1,864) in the 12 of 30 responders (11 chronic hepatitis, 1 cirrhosis) who maintained remission up to 1 yr after cessation of interferon treatment. Fourteen patients (7 chronic hepatitis, 7 cirrhosis) with autoantibodies (12 antinuclear, 2 anti-liver-kidney microsomal) were treated with prednisone. The mean viremia level significantly increased after 3 mo of treatment, even in face of ALT decrease.(ABSTRACT TRUNCATED AT 250 WORDS)