ASSESSMENT OF HEPATITIS-C VIRUS-RNA LEVELS BY QUANTITATIVE COMPETITIVE RNA-POLYMERASE CHAIN-REACTION - HIGH-TITER VIREMIA CORRELATES WITH ADVANCED-STAGE OF DISEASE

A quantitative competitive RNA polymerase chain reaction (QC-PCR) assa y was developed for measuring absolute levels of hepatitis C virus (HC V) RNA in the sera of 121 viremic persons, including 64 asymptomatic b lood donors, 39 symptomatic patients referred for treatment of chronic hepatitis C, and 18 patients with end-stage liver disease referred fo r liver transplantation. Mean HCV RNA levels (log molecules per millil iter) were lowest among blood donors with normal alanine aminotransfer ase (ALT) values (5.8 +/- 1.5), higher among blood donors with elevate d ALT (6.9 +/- 0.8) and clinic patients with chronic active hepatitis (6.9 +/- 0.7), and highest among patients with cirrhosis (7.1 +/- 0.8) or end-stage liver disease (7.6 +/- 1.0). High-titer viremia (greater than or equal to 7.5 logs/mL) was more frequent among patients with e nd-stage liver disease (14/18; 78%) than either blood donors (10/64; P <.001) or patients with chronic active hepatitis (7/26; P <.001). Thu s, 121 (94.5%) of 128 anti-HCV-positive persons were viremic. QC-PCR m ay be valuable for monitoring HCV infection status and selecting indiv iduals for therapy.