Detection of HCV RNA in the Livers of Patients with Undetectable Viral Load and Normal ALT

Hepatitis C virus (HCV) genetic material can remain in the livers of patients with undetectable serum HCV RNA, according to a study published in the July 1, 2006 issue of the Journal of Infectious Diseases.

Researchers from Madrid measured the presence of genomic (positive-strand) and anti-genomic (negative strand) HCV RNA in liver biopsy specimens and peripheral blood mononuclear cells (PBMC) obtained from 12 genotype 1 patients with normal alanine aminotransferase (ALT) levels who had positive HCV antibody tests, but negative PCR tests for serum HCV RNA for at least 12 months.

Results

All patients remained positive for HCV antibodies and negative for serum HCV RNA during a median follow-up period of 29 months; all also maintained normal ALT levels.

Genomic HCV RNA was detected in liver biopsy specimens from 10 out of 12 patients (83%).

Anti-genomic HCV RNA was detected in all 10 biopsy specimens that showed evidence of genomic HCV RNA.

Genomic HCV RNA was found in 6 out of 12 PBMC samples (50%), and anti-genomic HCV RNA was also detected in 5 of the 6 positive samples (83%).

Conclusion

The researchers concluded that HCV may persist and continue to replicate in the livers and white blood cells of healthy patients with undetectable serum HCV RNA and persistently normal ALT levels. They recommended that such patients should receive continuing follow-up, because they have an ongoing viral infection.

7/18/06

Reference
V Carreno, M Pardo, J M Lopez-Alcorocho, and others. Detection of Hepatitis C Virus (HCV) RNA in the Liver of Healthy, Anti-HCV Antibody-Positive, Serum HCV RNA-Negative Patients with Normal Alanine Aminotransferase Levels. Journal of Infectious Diseases 194(1): 53-60. July 1, 2006.