LOW-PREVALENCE OF HEPATITIS-C VIRUS-INFECTION IN PORPHYRIA-CUTANEA-TARDA IN GERMANY

Previous studies from Spain, Italy, and France have demonstrated a hig h prevalence (71% to 91%) of antibodies against hepatitis C virus in p atients with porphyria cutanea tarda (PCT), To determine the role of h epatitis C virus (HCV) in PCT in Germany, we have assessed the prevale nce of antibodies against HCV and hepatitis B virus (HBV) in 106 patie nts (mean age, 60 +/- 14 years) with the disease. Eight of 106 patient s (8%) were positive for HCV antibodies and HCV RNA using second-gener ation enzyme-linked immunosorbent assay (ELISA), recombinant immunoblo t assay, and polymerase chain reaction. Antibodies against HBV core an tigen were found in 14 patients (13%). Of the patients with antibodies against HCV alanine transaminase (ALT) (aspartate transaminase [AST]) levels above normal occurred in 71% (86%). Because elevated ALT (AST) levels were also found in 51% (64%) of 88 patients without markers of HCV or HBV, we suggest that liver damage in PCT may exist in absence of these viruses. This is supported by the finding that in patients wi thout HCV or HBV markers, higher serum ALT and AST activities were fou nd in patients with overt disease or relapse (ALT, 59 +/- 44 U/L; AST, 37 +/- 21 U/L), whereas patients in remission displayed significantly lower serum enzyme activities (ALT, 16 +/- 8 U/L; AST, 16 +/- 7 U/L), (P < .001), These results indicate that HCV infection does not play a major role in the pathogenesis of PCT in Germany.