Correlation of viral RNA, alanine aminotransferase, and histopathology in hepatitis C virus - associated hepatitis

Background: Hepatitis C virus (HCV) infection is usually monitored by the level of alanine aminotransferase (ALT) and histopathological changes in liver biopsy specimens. However, accumulating data indicate these parameters are not always correlated with disease progression or the response of HCV infection to therapy. Materials and Methods: Using the Amplicor PCR Monitor Test Kit (Roche Diagnostic Systems, Branchburg, NJ), HCV RNA level was measured in 38 patients with positive anti-HCV antibodies and in 21 of those patients after interferon treatment. The grade and stage of histological changes on hematoxylin and eosin-stained sections of liver biopsy specimens were evaluated on a scale of 1 to 4. In each case, the HCV RNA level was compared with the histological grade or stage and level of ALT and statistically analyzed by Student's t-test. Results: ALT level did not correlate with pretreatment and posttreatment levels of HCV RNA or histopathological changes. However, there was a statistically significant correlation between HCV RNA and histological grade (P <.05). Conclusion: HCV RNA measurement is a better means of determining and monitoring HCV infection than either ALT level or histopathological characteristics and may provide insight into hepatic injury caused by HCV infection even without an invasive liver biopsy.