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

Abstract

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 log₁₀ copies/mg of liver. Mean serum HCV–RNA level was 6.21 ± 0.72 log₁₀ 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 log₁₀ 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 log₁₀ 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 log₁₀ 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.