Natural fluctuations of hepatitis C viral load in a homogeneous patient population: A prospective study

The aim of this study was to determine the variation in hepatitis C viral l oad over an extended period of patient follow up. Serum samples were collec ted from 49 female individuals who were identified as having been infected from the same source of hepatitis C-contaminated anti-D immunoglobulin duri ng the period from 1977 (May) to 1978 (November), All patients attended the hepatitis C clinic at Cork University Hospital, Cork, Ireland. The study g roup was homogeneous with respect to gender, hepatitis C virus (HCV) genoty pe (Ib), and duration of infection. None of the patients had received antiv iral therapy at the time of completion of study, Viral load quantifications were assessed using the Roche Monitor (F. Hoffmann-la Roche, Ltd., Basel, Switzerland) assay. The mean age of the study group at time of infection wa s 30.3 years (SD +/- 6.1) with a range from 18.5 to 43 years. The mean time of follow-up was 4.1 years (SD +/- 1.0) with a range from 1.2 to 5 years. The mean rate of change of viral load per year was 0.23 log(10) viral copie s per mt serum for the study group (SD +/- 0.19) with a range of -0.18 to 0 .78 that was significantly different from zero, P < 10(-10). The rate of ch ange of viral load per year was negatively correlated with viral load at fi rst determination, r = -.35, P =.01. Age at infection did not correlate wit h the slope of change of viral load, P =.10, In conclusion, most women infe cted with HCV Ib will have an increase in viral load over time but a few pa tients who acquire infection early in adult life will show a decrease in vi ral load.