Hepatitis C Viral Load Is About More Than Numbers


06/05/2002
By Anne MacLennan

Hepatitis C viral (HCV) load does not correlate with the histological evolution of the disease, and use of viral RNA quantification as a predictor or determinant of severity of this disease is incorrect and of relative value.

These are the views of Evaldo Stanislau Affonso de Araujo and colleagues following an analysis of 58 patients at the Hepatitis Outpatient Clinic, Department of Infectious and Parasitic Diseases, Faculty of Medicine, University of Sao Paulo, (DMIP/FMUSP), Sao Paul, Brazil. Participants all had chronic hepatitis C confirmed by liver biopsy and detection of viral RNA in serum by nested polymerase chain reaction (PCR).

They were followed from 1997 to 1998. They received interferon-alpha subcutaneously three times per week for 12 months, blood samples were collected and processed before treatment, and six and 12 months after.

The virus was serotyped. A predominance of male patients with a mean age of 40 years was found and although most patients acquired the infection through blood transfusion and blood derivatives or through drug use, one third of the cases did not report any suspected epidemiology. Diagnosis was mainly made upon blood donation. Serotype 1 was the most common HCV subtype (30 cases, one co-infected with serotype 4), although 34 percent of the patients were non-1 (4 were type 2 and 16 type 3).

 In most cases, viral load was below 500,000 copies/ml. There was a predominance of patients with elevated HAI and slight structural alterations. Median viral load decreased during the first six months of treatment, but this reduction did not persist to the end of treatment.

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