Serum hepatitis C virus RNA levels and liver injury in volunteer blood donors.

Abstract

Liver histology in volunteer blood donors positive for serum hepatitis C virus RNA was investigated in relation to hepatitis C virus viremia levels. Twenty-one volunteer blood donors positive for serum hepatitis C virus RNA by polymerase chain reaction were monitored for at least 1 yr by monthly routine liver function tests and underwent liver biopsy. Liver histology findings were correlated with hepatitis C virus viremia levels assessed by a quantitative branched DNA assay. Liver histology showed the features of chronic hepatitis in 20 (95%) patients. Only one of the seven patients with persistently normal aminotransferase levels during follow-up had normal liver histology, and the others had chronic hepatitis. Sera obtained the same day of the liver biopsy were shown to contain hepatitis C virus RNA of 10(5.7)-10(7.6) equivalent/ml (median 10(6.7)). The total histological activity index score (median 2, range 0-15) and the scores of portal inflammation (median 1, range 0-3), lobular inflammation (median 1, range 0-4) and piecemeal necrosis (median 0, range 0-5) correlated with viremia levels (r = 0.64, p < 0.01; r = 0.60, p < 0.01; r = 0.48, p < 0.05; and r = 0.49, p < 0.05, respectively). These findings suggest that chronic hepatitis is frequently caused by hepatitis C virus infection irrespective of the serum aminotransferase levels, and high level hepatitis C virus replication is a contributory cause for liver injury in volunteer blood donor populations.