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(American Journal of Pathology. 1999;154:1877-1881.)
© 1999 American Society for Investigative Pathology

Regular Articles

Histological Damage in Chronic Hepatitis C Is Not Related to the Extent of Infection in the Liver

Elena Rodríguez-Iñigo^*, Javier Bartolomé^*, Susana de Lucas^*, Felix Manzarbeitia, Margarita Pardo^*, Carlos Arocena^*, Jaime Gosálvez, Horacio Oliva and Vicente Carreño^*

From the Department of Hepatology,^*
Fundación Jiménez Díaz and Fundación Estudio Hepatitis Virales, the Department of Pathology,
Fundación Jiménez Diaz, and the Department of Biology,
Science Faculty, Universidad Autónoma de Madrid, Madrid, Spain

It has not been completely elucidated whether the liver injury induced by the hepatitis C virus (HCV) is due to direct cytopathic damage or to an immune-mediated response against HCV-infected hepatocytes. In this work, we have determined the percentage of HCV-infected hepatocytes, the histological activity index, and the viremia levels in chronically HCV-infected patients with different grades of liver injury to investigate any possible correlation between them. For that purpose, liver biopsies from 27 patients with HCV chronic hepatitis were analyzed by in situ hybridization. This technique revealed that the percentage of infected hepatocytes ranged from 0.04% to 83.6%. Regarding the viremia levels, HCV RNA concentration ranged from 1.8 x 10³ to 1.4 x 10⁶ genome copies/ml. A significant correlation (r = 0.54; P = 0.003) between the percentage of infected hepatocytes and the viremia levels was found. In contrast, no correlation was observed between the percentage of HCV-infected hepatocytes or the viremia levels and the histological activity index. In conclusion, we have shown that the HCV viremia reflects the extent of the infection in the liver and that the liver injury in chronic HCV infection is not directly related to either the number of infected hepatocytes or the serum HCV RNA concentration.

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