Hepatitis C Viral Load Is About More Than Numbers
Hepatitis C Viral Load Is About More Than Numbers
A DGReview of :"Hepatitis c viral load does not predict disease outcome:
going beyond numbers"
Revista do Instituto de Medicina Tropical de São Paulo
06/05/2002
By Anne MacLennan
www.docguide.com
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.
A virological response was obtained in 21 cases and was sustained in 10
(17.2 percent), and a biochemical response was obtained in 19 cases and
sustained in nine (15.5 percent).
Histological analysis revealed a reduction in inflammatory activity and
maintenance of the favourable architectural profile.
These researchers conclude HCV RNA quantification plays a role in viral
dynamics and can provide an early prediction (24h to 48h) of a sustained
virological response. However, disease progression is more complex and does
not simply depend on viremia.
Rev. Inst. Med. trop. S. Paulo vol.44 no.2 São Paulo. "Hepatitis c viral
load does not predict disease outcome: going beyond numbers"