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G H Haydon
a Department of Medicine, b Department of Microbiology, c Department of Pathology, University of Edinburgh, UK
Correspondence to: Dr G H Haydon,
Department of Medicine, University of Edinburgh, Lauriston Place,
Edinburgh EH3 9YW, Scotland, UK. Accepted for publication 26 November 1997 Background Keywords:
intrahepatic hepatitis C virus;
chronic hepatitis C
virus infection
The clinical significance of a single
assessment of circulating hepatitis C virus (HCV) RNA and its relation
to the level of intrahepatic HCV RNA remains unclear.
AimsTo investigate the relation between
intrahepatic HCV levels and clinicopathological characteristics of
chronic HCV infection.
PatientsNinety eight consecutive patients with
chronic HCV infection were studied; none had received 
interferon
therapy. Of these, 12 patients were repeatedly negative for HCV RNA in serum by reverse transcriptase polymerase chain reaction (RT-PCR).
MethodsAfter diagnostic laparoscopy and liver
biopsy, semiquantitative analysis of intrahepatic HCV RNA levels was
carried out by limiting dilution of HCV cDNA. HCV genotypes were
assessed in 96 patients by restriction fragment length polymorphism
analysis of HCV cDNA.
ResultsTen out of 12 patients who were RT-PCR
negative for HCV RNA in serum were RT-PCR positive in liver; however,
this group had a significantly lower intrahepatic HCV level and serum aminotransferase level than the remaining 86 patients. Histological severity (cirrhosis: n=10); histological activity index; HCV genotype (genotype 1: n=41; genotype 2: n=12; genotype 3: n=36; genotype 4:
n=7); mode of infection (intravenous drug abuse: n=58;
post-transfusion: n=10; haemophiliac: n=4; sporadic: n=26) and alcohol
abuse did not affect the intrahepatic virus level. There was no
correlation between patient age, duration of infection, and
intrahepatic HCV level.
ConclusionsIntrahepatic virus levels were not
determined by host factors (age of patient, mode or duration of
infection) or by virus factors (HCV genotype). Repeatedly negative
RT-PCR for HCV RNA in serum does not indicate absence of HCV from the liver.
(GUT 1998;42:570-575)
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