Clinical significance of hepatic HCV RNA in patients with chronic hepatitis C demonstrating long-term sustained response to interferon-alpha therapy

• Published in: Journal of medical virology 1998-05, Vol.55 (1), p.7-11
• Main Authors: Larghi, Alberto, Tagger, Alessandro, Crosignani, Andrea, Ribero, Maria Lisa, Bruno, Savino, Portera, Giuseppe, Battezzati, Pier Maria, Maggioni, Marco, Fasola, Michele, Zuin, Massimo, Podda, Mauro
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Alanine Transaminase - blood; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Antiviral Agents - therapeutic use; Biological and medical sciences; Female; Follow-Up Studies; Hepacivirus - drug effects; hepatitis C virus; Hepatitis C, Chronic - blood; Hepatitis C, Chronic - drug therapy; Hepatitis C, Chronic - pathology; Hepatitis C, Chronic - virology; Human viral diseases; Humans; Infectious diseases; Interferon-alpha - therapeutic use; interferon-α; interferon‐α, therapy; Liver - pathology; Liver - virology; liver HCV RNA; long-term responders; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; RNA, Viral - analysis; therapy; Time Factors; Treatment Outcome; Viral diseases; Viral hepatitis
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/(SICI)1096-9071(199805)55:1<7::AID-JMV2>3.0.CO;2-7

Whether sustained biochemical response and absence of serum HCV RNA in the 6–12 months following suspension of interferon‐α (IFN‐α) therapy reflect definitive viral clearance in patients with chronic hepatitis C virus (HCV) infection is controversial. To obtain more information on this topic, HCV RNA was sought in both liver and serum samples of 25 long‐term responders who were followed for a median period of 39 months (range 21–79) after discontinuation of IFN‐α. Liver biopsy was undertaken before and 6 to 12 months after IFN‐α withdrawal. Liver and serum HCV RNA were tested by a nested polymerase chain reaction. Twenty‐two patients (88%) tested negative for both liver and serum HCV RNA, two patients had detectable HCV RNA in both liver and serum, and one patient showed persistent HCV RNA only in the liver. Post‐treatment liver histology improved markedly in all patients, including those with viral persistence. During further follow‐up, biochemical remission was maintained in all patients except one in whom both serum and liver specimens remained HCV RNA positive. The data indicate that the large majority of long‐term responders test negative for HCV RNA in the liver, which suggests definitive eradication of HCV RNA infection. J. Med. Virol. 55:7–11, 1998. © 1998 Wiley‐Liss, Inc.