Hepatitis C virus RNA profiles in chronically infected individuals: Do they relate to disease activity?

Fluctuations of hepatitis C virus (HCV)-RNA serum levels were monitored in a multicenter study in 76 chronic HCV carriers who had been followed longit udinally without receiving antiviral therapy to assess their relation with the course of liver disease activity. Forty-four patients had normal transa minases over more than 2 years, while 32 additional patients had fluctuatin g levels. Viral load was measured in serial serum samples prospectively col lected for 10 to 12 months in 54 patients and in sera stored yearly up to 8 years in an additional 22 patients. In patients tested monthly a lesser ex tent of fluctuations was detected in cases with constantly normal transamin ases as compared with those with fluctuating transaminases. In the former g roup, the mean difference between maximum and minimum values observed in ea ch individual patient was 0.7 Log, while in the latter group, it was 1.3 Lo g (P = .0004). Most of these patients experienced, on average, three peaks of viremia over 1 year. The range of variation observed upon yearly testing was between 0.2 and 2.2 Log and did not reach statistical significance bet ween the two groups. In conclusion, a careful viral replication profile can be achieved only by monthly testing, because longer time intervals could m iss viremia fluctuations. HCV-RNA levels are more stable in asymptomatic HC V carriers than in patients with biochemical activity of liver disease.