Factors Affecting Serum Concentrations of Hepatitis C Virus (HCV) RNA in HCV Genotype 1-Infected Patients with Chronic Hepatitis

摘要

The serum concentration of hepatitis C virus (HCV) RNA is usually stable (4 to 8 log₁₀ IU/ml) in untreated patients with chronic hepatitis C. While this baseline HCV RNA concentration ([HCV RNA]_BL) is predictive of a sustained virologic response to treatment, its determinants are only partially identified. We therefore analyzed the baseline characteristics of 2,472 HCV genotype 1-infected patients to identify correlations with gender, age, race, weight, body mass index (BMI), HCV acquisition mode, HCV subtype, alanine aminotransferase concentration, or histopathologic changes in the liver. After separation of the data according to four [HCV RNA]_BL groups (≤5.0, >5.0 to 5.6, >5.6 to 5.9, and >5.9 log₁₀ IU/ml), we determined that increasing [HCV RNA]_BL correlated (P < 0.05) with increasing proportions of patients who were male, >40 years of age, or heavier (a weight of >85 kg or a BMI of >27 kg/m2). Histologic activity index (HAI) data were available for 1,304 of these patients: increasing [HCV RNA]_BL correlated with higher fibrosis and necrosis-inflammation scores. As a continuous variable, [HCV RNA]_BL correlated with age, gender, weight (continuous or ≤85 versus >85 kg), BMI (continuous or ≤27 versus >27 kg/m2), subtype, fibrosis score, and necrosis-inflammation score; however, multiple-regression analysis yielded P values of <0.1 only for age, gender, BMI (≤27 versus >27 kg/m2), and fibrosis score. While our findings are suggestive of a role for these factors in maintenance of the pretreatment state of HCV infection, the multiple-regression model accounted for only ≤4.6% of the [HCV RNA]_BL differences between individuals (R2 = 0.046 for 1,304 patients with HAI scores; 0.043 for all 2,472 patients).