Correlation of viral RNA, alanine aminotransferase, and histopathology in hepatitis C virus - associated hepatitis

Background: Hepatitis C virus (HCV) infection is usually monitored by the l evel of alanine aminotransferase (ALT) and histopathological changes in liv er biopsy specimens. However, accumulating data indicate these parameters a re not always correlated with disease progression or the response of HCV in fection to therapy. Materials and Methods: Using the Amplicor PCR Monitor Test Kit (Roche Diagn ostic Systems, Branchburg, NJ), HCV RNA level was measured in 38 patients w ith positive anti-HCV antibodies and in 21 of those patients after interfer on treatment. The grade and stage of histological changes on hematoxylin an d eosin-stained sections of liver biopsy specimens were evaluated on a scal e of 1 to 4. In each case, the HCV RNA level was compared with the histolog ical grade or stage and level of ALT and statistically analyzed by Student' s t-test. Results: ALT level did not correlate with pretreatment and posttreatment le vels of HCV RNA or histopathological changes. However, there was a statisti cally significant correlation between HCV RNA and histological grade (P <.0 5). Conclusion: HCV RNA measurement is a better means of determining and monito ring HCV infection than either ALT level or histopathological characteristi cs and may provide insight into hepatic injury caused by HCV infection even without an invasive liver biopsy.