Circulating HCV‐RNA, HCV genotype, and liver histology in asymptomatic individuals reactive for anti‐HCV antibody and their follow‐up study

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Abstract
The present study was aimed to clarify the virologic status, liver histologies, and the results of follow‐up liver tests in symptom‐free individuals with anti‐HCV antibodies and normal liver tests. Forty‐nine individuals with normal liver tests and positive second generation anti‐HCV antibody assay were entered into this study. Cases with hepatitis C viremia were evaluated for HCV genotype, amount of circulating HCV‐RNA, and liver histology and were followed‐up for more than one year. Of the forty‐nine individuals, 36 had hepatitis C viremia, indicated by polymerase chain reaction (PCR) assay. Liver histology was as follows: 3 had non‐specific changes, 25 had chronic persistent hepatitis (CPH), and 8 had chronic active hepatitis (CAH). Twenty‐four cases with CPH and CAH developed an elevated AST and/or ALT concentration (> 30IU/1) between 12 and 32 months of follow‐up. The amount of circulating HCV‐RNA ranged from 102 to 107 copies/50 μl serum. The distribution of HCV genotypes was nearly the same as that for symptomatic CAH. These data suggest that the histological examination and follow‐up examination are very important for following symptom‐free individuals with hepatitis C viremia because there are some candidates for interferon therapy among them. There are few individuals who will remain healthy among asymptomatic HCV carriers.