NDLI: Histological changes in HCV antibody-positive, HCV RNA-negative subjects suggest persistent virus infection.

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Histological changes in HCV antibody-positive, HCV RNA-negative subjects suggest persistent virus infection.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Hoare, Matthew Gelson, William T. H. Rushbrook, Simon M. Curran, Martin D. Woodall, Tracy Coleman, Nicholas Davies, Susan E. Alexander, Graeme J. M.
Description	Country affiliation: United kingdom Author Affiliation: Hoare M ( Department of Medicine, School of Clinical Medicine, University of Cambridge, Cambridge, UK.)
Abstract	UNLABELLED: It is unclear whether hepatitis C virus (HCV) has been eradicated or persists at a low level in HCV antibody-positive HCV RNA-negative individuals. The natural history and liver histology are not well characterized. One hundred seventy-two HCV antibody-positive, serum HCV RNA-negative patients underwent diagnostic liver biopsy between 1992 and 2000 and were followed a median 7 years (range, 5-12). Patients with any possible cause of liver injury other than HCV were excluded. A single histopathologist scored sections using Ishak criteria. Characterization of the inflammatory infiltrate in selected cases used a novel semiquantitative technique and compared with HCV RNA-positive patients and healthy controls. One hundred two patients were excluded because of a risk factor for liver injury other than HCV. Seventy patients met the study criteria; four (5.7%) became HCV RNA-positive during follow-up. Sixty-six cases remained HCV RNA-negative; five (7.5%) had a normal liver biopsy; 54 (82%) had fibrosis (stage 2 or 3 in 16 (24%)). Nonviremic cases revealed expanded portal tracts (P < 0.05), with fewer CD4+ (P < 0.05) and more CD8+ cells (P < 0.05) than healthy controls, but were indistinguishable from HCV RNA-positive cases for these parameters. Lobular CD4 staining, absent in healthy controls, was noted in both HCV RNA-negative and -positive cases and was more marked in the latter (P < 0.05) with a sinusoidal lining cell distribution. CONCLUSION: Nonviremic HCV antibody-positive patients have a liver biopsy that is usually abnormal. Fibrosis was present in most with similar inflammatory infiltrate to viremic cases. The presence of a CD8+ rich inflammatory infiltrate suggests an ongoing immune response in the liver, supporting the view that HCV may persist in the liver in the majority of HCV RNA-negative cases.
File Format	HTM / HTML
ISSN	02709139
e-ISSN	15273350
DOI	10.1002/hep.22484
Journal	Hepatology
Issue Number	6
Volume Number	48
Language	English
Publisher	Wiley
Publisher Date	2008-12-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Hepatology Hepacivirus Genetics Hepatitis C Antibodies Blood Hepatitis C Rna, Viral Alanine Transaminase Metabolism Antigens, Cd3 Biopsy Cd8-positive T-lymphocytes Pathology Case-control Studies Cohort Studies Disease Progression Immunology Diagnosis Liver Virology Liver Cirrhosis Perforin Prognosis Virus Replication Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Hepatology

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Histological changes in HCV antibody-positive, HCV RNA-negative subjects suggest persistent virus infection.