RELATIONSHIP OF GENOTYPE TO LEVEL OF HEPATITIS-C VIREMIA DETERMINED BY COMPETITIVE POLYMERASE CHAIN-REACTION

To compare the levels of hepatitis C virus (HCV) viraemia in carriers of the same genotype in various stages of chronic HCV infection, we quantified the amount of HCV RNA by competitive polymerase chain reaction and determined HCV genotype using type-specific primers. The study population included 255 patients with chronic HCV infection (asymptomatic 33, chronic hepatitis 141, liver cirrhosis 50, hepatocellular carcinoma 31). Of these 255, the prevalence of HCV RNA genotype II was 67.8%, genotype III, 17.3% and genotpye IV, 14.9%; no genotype I was found. The level of HCV RNA (logarithmic transformed copy numbers per 50 mu l of serum) was significantly higher in subjects of genotype Il than in those of genotypes III or IV (mean titre 5.8 +/- 1.0 vs, 5.1 +/- 1.2 and 4.8 +/- 1.1, P<0.05, respectively). There was no significant difference in the level of HCV RNA between genotypes III and IV. Of 173 patients of genotype II, there were no significant differences between the level of HCV RNA and the stage of liver disease or in the level of HCV RNA by age. Of the 129 with genotype II with a history of blood transfusion, there was no significant difference between the level of HCV RNA of patients with and without a history of transfusion or between that of patients with a history of blood transfusion and the time elapsed since blood transfusion. The level of HCV viraemia depended on the genotype of HCV RNA and did not correlate to age or to the stage of liver disease. We conclude that the genotype of HCV RNA should be given attention in order to provide more effective treatment.