Digestive Diseases and Sciences

, Volume 46, Issue 8, pp 1677–1683 | Cite as

Serum HCV RNA Levels Correlate with Histological Liver Damage and Concur with Steatosis in Progression of Chronic Hepatitis C

  • Luigi E. Adinolfi
  • Riccardo Utili
  • Augusto Andreana
  • Marie-Francoise Tripodi
  • Marta Marracino
  • Michele Gambardella
  • Mariagrazia Giordano
  • Giuseppe Ruggiero


The role of HCV RNA levels and host factors in the severity of liver injury was studied. Enrolled were 298 consecutive liver biopsy-proven chronic hepatitis (CH) C patients (179 men; median age: 52 years, range 19–68; CH, 198; cirrhosis, 100) and 18 chronic hepatitis C with normal ALT. HCV genotypes were: 1a, 4.3%; 1b, 53%; 2a/c, 28%; 3a, 7%; 4, 1.3%, and mixed 6.4%. Serum HCV RNA levels were similar for all genotypes (median: 2.8 × 106 eq/ml; range <0.2–69). In patients with chronic hepatitis without cirrhosis, the serum HCV RNA levels reflected the grade of liver necroinflammatory activity (R = 0.45; P < 0.001) and the stage of fibrosis (R = 0.51; P < 0.001), regardless of age, gender, HCV genotype, hepatic steatosis, and hepatic iron overload. Patients with high serum HCV RNA levels (≥3 × 106 eq/ml) had higher ALT values (P < 0.002) than those with lower HCV RNA levels. Patients with normal ALT showed low HCV RNA levels (median: 0.82 × 106 eq/ml) and histological features of minimal or mild chronic hepatitis. Cirrhotic patients showed significantly lower levels of viremia than those with chronic hepatitis with a similar HAI. The data of a subgroup of 62 patients with an established time of infection showed that for a similar duration of disease, patients with serum HCV RNA levels ≥3 × 106 eq/ml had a significantly higher fibrosis score than those with lower levels. HAI and fibrosis score were significantly higher in patients with HCV RNA levels ≥3 × 106 eq/ml and grade 3–4 steatosis than those with lower HCV RNA levels and steatosis grades. The data indicate that the liver damage is correlated with the HCV RNA levels and that a high viral load acts together with steatosis in accelerating the progression of liver injury.

HCV RNA levels HCV genotype chronic hepatitis C cirrhosis 


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Copyright information

© Plenum Publishing Corporation 2001

Authors and Affiliations

  • Luigi E. Adinolfi
    • 1
  • Riccardo Utili
    • 1
  • Augusto Andreana
    • 1
  • Marie-Francoise Tripodi
    • 1
  • Marta Marracino
    • 1
  • Michele Gambardella
    • 1
  • Mariagrazia Giordano
    • 1
  • Giuseppe Ruggiero
    • 1
  1. 1.Institute of Medical Therapy, Faculty of MedicineSecond University of NaplesNaplesItaly

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