CLINICAL-SIGNIFICANCE OF SERUM HEPATITIS-C VIRUS (HCV) RNA AS MARKER OF HCV INFECTION

We have evaluated the clinical significance of hepatitis C virus (HCV) RNA determination by analyzing a group of 221 hospitalized patients w ith abnormal liver function tests. Serum HCV: RNA was detected by ''ne sted'' PCR amplification followed by nonisotopic hybridization. Of the 200 (90.5%) patients with anti-HCV-positive enzyme-linked immunosorbe nt assay results, 152 (76%) were RIBA. reactive, 47 (23.5%) had indete rminate results, and 1 (0.5%) was nonreactive. Of the 180 (90%) patien ts positive for anti-HCV and HCV RNA, 138 (76.7%) were RIBA reactive a nd 42 (23.3%) were RIBA indeterminate. The pattern of RIBA reactivity did not correlate with the presence of HCV RNA. Elevated alanine amino transferase levels were associated neither with the presence of viremi a nor with the RIBA pattern. Histological findings consistent with non -A non-B hepatitis correlated with the presence of HCV RNA but not wit h the RIBA pattern. HCV RNA was detected in 11 of 21 (52.4%) anti-HCV- negative patients. These 11 patients were either immunosuppressed or i n the prodromic phase of acute hepatitis C. Circulating HCV RNA can th erefore be described as being predictive of virus induced liver damage in anti-HCV-positive patients and may be useful in the diagnosis of H CV infection in anti-HCV-negative immunosuppressed patients or in thos e with early acute infection.