VIREMIA AND HISTOLOGICAL GRADING OF CHRON IC HEPATITIS-C

We determined the correlation between viremia in serum specimens, tran saminase activity (ALT and AST) and histological grading in 37 patient s with chronic hepatitis C, III addition we compared two PCR methods f or hepatitis C virus (HCV)-RNA in serum specimens. For tile histologic al grading we used a modified Knodell score. For detection and quantif ication we measured the viremia (HCV-RNA titer) with a standardized '' nested primer'' PCR (end-point dilution method) and the commercially a vailable Amplicor HCV Monitor(TM), The mean HCV-RNA and AST level was significantly higher in patients with a histologically active inflamma tion. In the individual patient ws could not conclude from file titer of HCV-RNA on the histologic grading because of the wide range of the results. We did not find a significant difference in ALT in patients h aving varying histological gradings, HCV-RNA titer and transaminases ( ALT and AST) did not correlate significantly. The HCV-RNA titer was si gnificantly marked in older patients (above 40 years) and patients hav ing sporadic hepatitis than in younger patients and patients with chro nic hepatitis after drug abuse. The ''nested primer'' PCR (end-point d ilution method) was more sensitive for detection of HCV-RNA in serum s pecimens than Amplicor HCV Monitor(TM). The lack of HCV-RNA with Ampli cor HCV Monitor(TM) in 12 of 37 patients (32%) did not rule our viremi a. We conclude that in patients with a chronic hepatitis C marked vire mia points to a histologically active inflammation, In the individual patient we could not conclude from the titer of HCV-RNA on the histolo gical grading. Because of the lower sensitivity of Amplicor HCV Monito r(TM) it is necessary to confirm negative results with a ''nested prim er'' PCR.