Histological damage in chronic hepatitis C is not related to the extent ofinfection in the liver

It has not been completely elucidated whether the liver injury induced by t he hepatitis C virus (HCV) is due to direct cytopathic damage or to an immu ne-mediated response against HCV-infected hepatocytes. in this work, we hav e determined the percentage of HCV-infected hepatocytes, the histological a ctivity index, and the viremia levels in chronically HCV-infected patients with different grades of liver injury to investigate any possible correlati on between them. For that purpose, liver biopsies from 27 patients with HCV chronic hepatitis were analyzed by in situ hybridization. This technique r evealed that the percentage of infected hepatocytes ranged. from 0.04% to 8 3.6%, Regarding the viremia levels, HCV RNA concentration ranged from 1.8 x 10(3) to 1.4 x 10(6) genome copies/ml. A significant correlation (r = 0.54 ; P = 0.003) between the percentage of infected hepatocytes and the viremia levels was found. In contrast, no correlation was observed between the per centage of HCV-infected hepatocytes or the viremia levels and the histologi cal activity index. In conclusion, we have shown that the HCV viremia refle cts the extent of the infection in the liver and that the liver injury in c hronic HCV infection is not directly related to either the number of inferr ed hepatocytes or the serum HCV RNA concentration.