In situ distribution of hepatitis C virus (HCV) RNA in the liver: Relationship to histopathology and serum HCV-RNA levels

Abstract

In situ hybridization (ISH) technique has been applied to 60 liver biopsies obtained from Egyptian patients with chronic HCV hepatitis in an attempt to: assess the tissue localization of HCV RNA in the liver and to investigate its relationship to the liver pathology, serum level of alanine transaminase (ALT) and viral load in the serum. No similar studies have been reported from Egypt, which is an area of high HCV prevalence. ISH labeling for HCV was observed in 24 of the 60 liver biopsies from HCV infected patients (40%) as compared to the complete negative ISH results in the 10 control liver biopsies from patients with non HCV hepatitis. ISH positivity was seen only in the liver cells and it was usually cytoplasmic. ISH results were not significantly related to the patients' age, sex, histologic features of HCV hepatitis, grade of disease activity, stage of fibrosis, serum ALT levels or serum HCV RNA. However, ISH was statistically correlated to the grade of liver cell dysplasia (r=0.49, P<0.0001). The latter was also significantly correlated to the level of HCV RNA in the serum as measured by branched DNA technique (r=0.75, P<0.0001). In conclusion, the present study suggests that the load of HCV RNA in the liver is not related to extent of liver injury, serum ALT levels or the viral load in the serum. More importantly, the significant correlation between the grade of dysplasia and both the tissue and serum load of the virus, leads to the assumption that HCV has a direct carcinogenic effect on liver cells. Undoubtedly, these results are encouraging to plan for more large-scale studies on HCV hepatitis which is endemic in Egypt.