ABSTRACT
Objective To explore the correlation of serum HCV-RNA level with liver function indices and blood routine parameters in patients with hepatitis C,and provide the references for the early diagnosis and monitoring the prognosis of hepatitis C.Methods The study population comprised 651 patients who were diagnosed with hepatitis C in the Second Affiliated Hospital of Medical College of Xi' an Jiaotong University.Serum level of HCV RNA was determined by quantitative realtime polymerase chain reaction (real-time PCR).The data obtained were divided into six groups according to the result of HCV RNA level.Then the correlation of serum HCV-RNA level with liver function indices and blood routine parameters was analyzed.Results With the rising level of serum HCV-RNA,the levels of liver function indices including ALT,AST,AST/ALT,GGT and TBIL were all significant increased in hepatitis C patients.However,A/G presented a declining trend with the increase of serum HCV-RNA level.The lowest value and highest value of ALT,AST,AST/ALT,GGT,TBIL and A/G were 32.3±9.7 U/L and 96.2±13.6 U/L,31.1±8.38 U/L and 113.5±15.9 U/L,0.86±0.09 and 1.19±0.11,29.2± 14.5 U/L and 52.7±16.2 U/L,17.2±4.32 μmol/L and 26.0±5.58 μmol/L,0.98±0.07 and 1.35±0.14,respectively.Significant differences in ALT,AST,AST/ALT,GGT,TBIL and A/G were observed among these groups (F value was 457.1,656.4,149.1,40.18,46.56 and 146.98,respectively.all P＜0.01).Moreover,the levels of blood routine parameters including WBC,NEUT％,RBC,H b and PLT were all significant decreased while that of LY％ was increased with the rising level of serum HCV-RNA in hepatitis C patients.The lowest value and highest value of WBC,NEUT％,LY％,RBC,Hb and PLT were (4.30±0.22) ×109/L and (6.02±0.27) × 109/L,(48.13±3.56)％ and (59.28±3.40)％,(31.05±3.41) ％ and (38.81 ± 4.65)％,(3.73 ± 1.70) × 1012/L and (4.65± 1.88) × 1012/L,(122.01±5.58) g/L and (135.37 ±8.50)g/L,(102.65± 16.87) × 109/L and (148.21 ± 14.40) × 109/L,respectively.There was no significant difference in RBC among groups (F=1.926,all P＜0.05).However,the differences in other blood routine parameters than RBC among groups were statistically significant (F value of WBC,NEUT％,LY％,Hb and PLT was 349.0,132.145,43.65,38.91 and 52.21,respectively.all P＜0.01).Conclusion Serum HCV-RNA level was correlated with routine liver function indices and blood routine parameters.It is important to perform the combined detection of serum HCV-RNA level,routine liver function indices and blood routine parameters in hepatitis C patients,which can help to guide diagnosis and to evaluate the prognosis.
ABSTRACT
BACKGROUND/AIMS: Although interferon-a(IFNa) is currently the most effective antiviral agent for treating patients with chronic hepatitis C, its efficacy is not always reliable. Factors suggested to infruence outcome of IFN-a therapy for chronic hepatitis C are histological activity, level of viremia and HCV genotype, etc. The aim of this study was to determine the relationship between several pretreatment factors and response to IFN-a therapy in patients with chronic HCV infection. METHODS: Fifty-four patients with chronic HCV infection(47 with chronic hepatitis and 7 with liver cirrhosis) who received IFN-a(2a or 2b) therapy(3 6 MU, three times a week, for 3 12 months) were included. Level of serum HCV RNA(50 patients), HCV genotype(27 patients) and IgM anti- HCV(21 patients) during pretreatment period were assayed. RESULTS: Overall, 19(35%) subjects achieved sustained response(SR), 12(22%) had transient response(TR) and 23(43%) did not respond (nonresponse;NR). Mean age of patients with SR, TR and NR was 46+ 10, 51+ 7.5 and 54+ 9.7 years, respectively(p<0.05 between SR and NR). Among 30 patients with biopsy-proven chronic hepatitis, 13(43%) achieved SR;but only one(14%) in 7 patients with liver cirrhosis. Mean serum HCV RNA level(X10' copies/ml) was higher in nonresponders(7,7+ 13.0) compared with SR(2.3+ 2. 7) or TR(3.1+ 4.9), although statistically insignificant HCV genotyping in 27 patients revealed type la in 5(18.5%), 1b in 14(52%), 2a in 5(18.5%), 2b in 1(3.7%) and 4 in 2(7%), respectively. In non-1b patients, SR rate was significantly higher than 1b patients(69.2% vs. 21.4%, p=0.03). Although IgM anti-HCV was positive in 12(57%) among 21 patients studied, the positive rate and the titer of IgM anti-HCV was not significantly different in three groups. CONCLUSION: Our results suggest that in patients with chronic hepatitis C, infection with genotype 1b, old age, high serum HCV RNA level and the presence of cirrhosis would predict poor response to IFN therapy.