HEPATITIS-C VIRUS-RELATED LIVER-DAMAGE IS RELATED TO COLD ACTIVATION OF COMPLEMENT

A high positivity of cold activation of complement has been reported i n Japanese patients having hepatitis B virus-negative chronic hepatiti s. Although the cause of cold activation of complement is unknown, the involvement of hepatitis C virus (HCV) has been suspected. We studied the positivity of cold activation of complement in 253 patients, incl uding 93 patients with chronic hepatitis C infection who received 6MU natural interferon-cx per day for 24 continuous weeks. Cold activation was positive in 38% of patients with chronic hepatitis C and in 46% o f patients with liver cirrhosis C. We did not detect cold activation i n asymptomatic HCV carriers; patients with chronic hepatitis B, liver cirrhosis B, or alcohol-related liver damage; or in the controls. Cold activation was also negative in HCV-RNA-negative patients who respond ed completely to interferon-alpha, and in HCV-RNA-positive patients wh o responded partially whose serum alanine transaminase levels were nor malized after interferon treatment. In the patients who had a relapse of hepatitis C after interferon treatment, positivity of cold activati on increased sharply. We conclude that HCV-associated liver damage is related to the development of cold activation of complement. Cold acti vation is useful for monitoring the response to interferon in patients with chronic hepatitis C infection.