Viral RNA in duodenal bile of cirrhotic patients with chronic hepatitis C.

Abstract

Hepatitis C virus (HCV) has been detected in blood, saliva, urine, semen, breast milk, and tears. To our knowledge, bile has not yet been investigated. We observed histologic immunoreactivity in bile with an antibody to c100 protein in four of five HCV-positive cirrhotic livers, but also in two HCV-negative controls owing to a focally present cross-reacting antigen. We collected duodenal bile from 13 cirrhotic patients during endoscopic evaluation of varices (10 HCV, three controls) and assayed for HCV by reverse transcriptase polymerase chain reaction. Viral RNA was detected in the bile of 8 of 10 seropositive patients and in 0 of 3 seronegative controls. Hepatitis C virus RNA and an antigen immunoreactive with anti-c100 protein are present in bile in a proportion of cirrhotic patients with chronic HCV. It remains to be determined whether the virus is intact or degenerate, and whether it is shed into bile from hepatocytes or is a contaminant from blood or other secretions.