SERUM HEPATITIS-C VIRUS-RNA LEVELS AND LIVER-INJURY IN VOLUNTEER BLOOD-DONORS

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.