HEPATITIS-C VIRUS MARKERS IN PATIENTS WITH LONG-TERM BIOCHEMICAL AND HISTOLOGICAL REMISSION OF CHRONIC HEPATITIS

We measured hepatitis C virus (HCV) RNA and antibodies against HCV rec ombinant proteins (C22/S1, E1/S2, E2/NS1, C33/NS3, C100/NS4, NS5) in s erial serum samples from 22 interferon-treated patients with a long-te rm follow up (range: 36-44 months). Eleven of them showed persistently normal liver function tests and a significant histological ameliorati on or a complete resolution of chronic hepatitis (long-term responders , LTRs). In the remaining 11 patients (non-responders (NRs)) liver fun ction tests normalized temporarily during therapy or remained unchange d. At the end of the follow up (3 years), viraemia was undetectable in six of II LTRs (54.6%). HCV-RNA was always detectable in the serum of NRs (p = 0.017). At admission, anti-C22/S1, anti-E1/S2, anti-E2/NS1, anti-C33/NS3, anti-C100/NS4 and anti-NS5 were detected in 95.4%, 40.9% , 77.3%, 95.4%, 72.7% and 77.3% of the patients, respectively. Three y ears after suspension of therapy, anti-C100/NS4 was undetectable in fi ve of six (83.3%) LTRs who cleared HCV-RNA and in only one with ongoin g viraemia (20%). Anti-E2/NS1 was undetectable in 54.5% of LTRs and in no NRs (p = 0.067). Anti-E1/S2 was detected more frequently in LTRs t han in NRs (81.8% vs 45.5%). Serum levels of anti-C22/S1, C33/NS3 and NS5 did not change during therapy and the follow up in either group of patients. The clearance of viraemia in LTRs was associated with that of anti-C100/NS4 (p = 0.017). Serum HCV-RNA and anti-C100/NS4 appear s uitable tools for monitoring patients who respond to therapy. More tha n 40% of LTRs remained HCV-RNA-positive in spite of the biochemical re mission of their liver diseases.