Hepatitis C viral load does not predict disease outcome: going beyond numbers

Abstract

SUMMARYThe analysis of 58 patients with chronic hepatitis C without cirrhosis and treated with interferon-alpha demonstrated that hepatitis C viral (HCV) load does not correlate with the histological evolution of the disease (p = 0.6559 for architectural alterations and p = 0.6271 for the histological activity index). Therefore, the use of viral RNA quantification as an evolutive predictor or determinant of the severity of hepatitis C is incorrect and of relative value. A review of the literature provided fundamental and interdependent HCV (genotype, heterogeneity and mutants, specific proteins), host (sex, age, weight, etc) and treatment variables (dosage, time of treatment, type of interferon) within the broader context of viral kinetics, interferon-mediated immunological response (in addition to natural immunity against HCV) and the role of interferon as a modulator of fibrogenesis. Therefore, viral load implies much more than numbers and the correct interpretation of these data should consider a broader context depending on multiple factors that are more complex than the simple value obtained upon quantification.

Chronic hepatitis C virus in the state of Piauí, northeastern Brazil

“…The mean age of our patients was about 48 years, similar to what has been described in other studies in Brazil [11,13,17,24,28]. There was no difference between mean ages in patients with genotypes 1 and 3 (48.0 and 47.7 years old, respectively), similar to what was found by Bassit et al in São Paulo [24].…”