N. Yuki et al., SERUM HEPATITIS-C VIRUS-RNA LEVELS AND LIVER-INJURY IN VOLUNTEER BLOOD-DONORS, The American journal of gastroenterology, 89(9), 1994, pp. 1462-1466
Objectives: Liver histology in volunteer blood donors positive for ser
um hepatitis C virus RNA was investigated in relation to hepatitis C v
irus viremia levels. Methods: Twenty-one volunteer blood donors positi
ve for serum hepatitis C virus RNA by polymerase chain reaction were m
onitored for at least 1 yr by monthly routine liver function tests and
underwent liver biopsy. Liver histology findings were correlated with
hepatitis C virus viremia levels assessed by a quantitative branched
DNA assay. Results: Liver histology showed the features of chronic hep
atitis in 20 (95%) patients. Only one of the seven patients with persi
stently normal aminotransferase levels during follow-up had normal liv
er histology, and the others had chronic hepatitis. Sera obtained the
same day of the liver biopsy were shown to contain hepatitis C virus R
NA of 10(5.7)-10(7.6) equivalent/ml (median 10(6.7)). Th, total histol
ogical activity index score (median 2, range 0-15) and the scores of p
ortal inflammation (median 1, range 0-3), lobular inflammation (median
1, range 0-4) and piecemeal necrosis (median 0, range 0-5) correlated
with viremia levels (r = 0.64, p < 0.01; r = 0.60, p < 0.01; r = 0.48
, p < 0.05; and r = 0.49, p < 0.05, respectively). Conclusions: These
findings suggest that chronic hepatitis is frequently caused by hepati
tis C virus infection irrespective of the serum aminotransferase level
s, and high level hepatitis C virus replication is a contributory caus
e for liver injury in volunteer blood donor populations.