LONGITUDINAL-STUDY OF HEPATITIS-C VIREMIA IN CHRONIC HEPATITIS-C

Serial serum samples from 20 untreated patients with chronic hepatitis C virus (HCV) infection were tested for HCV RNA by a nested polymeras e chain reaction assay using primers from the highly conserved 5' nonc oding region to determine the relationship between hepatitis C viremia and the activity of liver disease during the natural course of chroni c HCV infection. Semiquantitation of serum HCV RNA level was achieved by testing serial 10-fold dilutions of RNA extracts to determine the e nd-point titer. All the patients were HCV RNA positive at presentation . There was a poor correlation between the initial HCV RNA titer and s erum transaminase levels. All patients except one were persistently HC V RNA positive during a follow-up period of 1.5-15 years, although 17 (85%) had periods of normal or near-normal transaminase levels. There was no correlation between changes in the serum transaminase levels an d HCV RNA titer. Patients with chronic HCV infection have persistent v iremia despite fluctuations in ALT levels. (C) 1993 Wiley-Liss, Inc.