CHRONIC LIVER-DISEASE AND ACTIVE HEPATITIS-C VIRUS-INFECTION IN PATIENTS WITH ANTIBODIES TO THIS VIRUS

Aims-To assess the association between active hepatitis C virus (HCV) infection and liver damage in randomly selected patients with antibodi es to the virus.Methods-Thirty three consecutive subjects with serolog ically confirmed positivity for antibodies to HCV were studied for the presence of liver and circulating viral sequences by using the revers e transcription polymerase chain reaction (RT-PCR) and specific primer s for the 5'-untranslated region (5'-UTR) of the HCV genome. Parallel clinical, biochemical, and histological investigations were carried ou t in all cases. Results-A comparative virological and histological inv estigation showed the presence of molecular signs of active viral repl ication and different degrees of liver damage in all cases. Baseline v alues of liver and plasma samples from all the patients showed (with o ne exception) the presence of detectable HCV RNA sequences, despite al anine amino transferase activities being within normal values or withi n 1.5 times the upper limit of normal in 13 of them. Examination of pe rcutaneous liver biopsy specimens showed the presence of confirmed Liv er damage (ranging from chronic persistent hepatitis to cirrhosis) in all 33 patients. Conclusions-Circulating HCV RNA sequences (a direct s ign of active HCV infection) are associated with liver damage, even in the absence of clinical or biochemical signs of overt liver disease. Parallel molecular, histological, and clinical follow up of these pati ents is needed to understand precisely the natural history of HCV infe ction and for correct clinical management.