FACTORS ASSOCIATED WITH SERUM HCV RNA POSITIVITY IN ANTI-HCV ANTIBODY-POSITIVE INTRAVENOUS-DRUG-USERS

Serum hepatitis C virus (HCV) RNA, HCV genotypes and liver function te sts were evaluated in a series of 189 unselected, consecutive anti-HCV positive intravenous drug users (IVDUs). Serum HCV RNA was detected i n 106/189 patients. Abnormal liver function tests were associated with alcohol abuse, but not with the presence of serum HCV RNA. Among 109 patients retested after a mean follow-up of 21 months, 41 were intermi ttently serum HCV RNA positive. Patients persistently negative had mor e commonly a past history of acute hepatitis. A history of prostitutio n and/or a pattern of abuse involving >30 injections per week were rel ated to infection by genotype 3a. In conclusion, serum HCV RNA is eith er transiently or persistently detectable in most anti-HCV positive IV DUs, but bears no association with abnormal liver biochemistry. Infect ion by HCV-3a is more common in IVDUs with more deviant life styles. I n those cases where serum HCV RNA is found repeatedly negative, HCV in fection may have been cleared, possibly through an episode of acute he patitis. (C) 1998 Elsevier Science Inc.