CHANGES IN HEPATITIS-C VIRUS-ANTIGEN IN LIVER WITH ANTIVIRAL THERAPY

Background: Although it has recently become possible to detect hepatitis C viral antigens in liver biopsy specimens, the frequency and clinical significance of this finding remains uncertain. Therefore, 49 liver biopsy specimens from 35 patients with hepatitis C were studied to make these assessments. Methods: Hepatitis C virus antigen was detected by immunofluorescence staining of snap-frozen liver biopsy sections. Results: Hepatitis C virus antigen was present in 86% of patients; the amount and pattern of hepatitis C virus antigen staining did not correlate with the degree of hepatic injury as assessed by serum aminotransferase levels or liver histology or with the level of viral replication assessed by the titer of HCV RNA in serum. Patients who had a beneficial response to antiviral therapy had significantly less hepatitis C virus antigen staining in pretreatment liver biopsy specimens than those who did not respond. The degree of hepatitis C virus antigen staining decreased significantly following interferon alfa therapy but not after ribavirin therapy. Hepatic hepatitis C virus antigen became undetectable after therapy in those patients who had a long-term beneficial response to therapy. Conclusions: Hepatic hepatitis C virus staining may be useful in predicting and monitoring the response to antiviral therapy. © 1993.