Role of hepatic HCV-RNA level on the severity of chronic hepatitis C and response to antiviral therapy.

BACKGROUND

Correlation between hepatic HCV-RNA and serum HCV-RNA, severity of liver disease and response to therapy is poorly known.

OBJECTIVES

To assess the influence of hepatic HCV-RNA level on severity of liver disease and response to therapy in a large cohort of chronic hepatitis C (CHC) patients.

STUDY DESIGN

HCV-RNA was measured in frozen liver biopsies and serum samples from 130 CHC patients the day of liver biopsy prior to treatment. Liver fibrosis was assessed by Ishaq scoring. A Sustained Virological Response (SVR) was observed in 52% of the patients, non-response (NR) in 34%.

RESULTS

Mean±standard deviation hepatic HCV-RNA level was 7.69±0.67 log(10) copies/mg of liver. Mean serum HCV-RNA level was 6.21±0.72 log(10) copies/ml. There was a correlation between hepatic and serum HCV-RNA in genotype 1 and 4 (p=0.008 and p=0.03) and age (p=0.006). Mean hepatic HCV-RNA was 7.70±0.69 vs 7.67±0.68 log(10) copies/mg of liver, in patients with significant fibrosis vs those with mild fibrosis, respectively (p=0.7); 8.04±0.68; 7.44±0.47; 7.43±0.49 and 7.44±0.71 log(10) copies/mg of liver in genotypes 1, 2, 3 and 4, respectively (p=0.0001); higher in women than in men (p=0.04); 7.60±0.63, 7.71±0.54 and 7.96±0.73 log(10) copies/mg in SVR, relapsers and NR, respectively (p=0.1). Multivariate analysis showed that high hepatic HCV-RNA level was independently associated with genotype and response to therapy was associated with genotype independently from hepatic HCV-RNA level.

CONCLUSIONS

Hepatic HCV-RNA level was not associated with severity of liver disease. High level was strongly associated with HCV genotype independently from response to therapy.