Persistently abnormal liver function tests: Marker of occult he...( biopsies from 40 (70%) of the 57 patien...),Health

biopsies from 40 (70%) of the 57 patients. The second method used was in situ hybridization, which demonstrated positive-strand HCV RNA in liver biopsies from the same 57 patients, but in none of those from the controls, and negative-strand HCV RNA in 48 (84%). The investigators noted that the latter finding suggested viral replication, which involves synthesis of a negative RNA intermediary.

The RT-PCR assay also detected HCV RNA in peripheral-blood mononuclear cells from 40 (70%) of the 57 patients with occult infection. The clinical implication of this finding, the investigators noted, is that a high percentage of patients with occult HCV infection may be more easily and more safely identified by obtaining and testing blood cells rather than liver cells.

In an accompanying editorial, Herv Lerat, MD, and F. Blaine Hollinger, MD, of Baylor College of Medicine, Houston, commented that the distribution of hepatic enzyme elevations in the study population implied that clinicians should use both ALT and GGT to identify patients who may qualify for peripheral-blood mononuclear cell testing for occult HCV infection. They cautioned, however, that many issues about such infections remain to be resolved, including the central issue of whether the detected viral genomic material is infectious.

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Contact: Diana Olson
dolson@idsociety.org
703-299-0201
Infectious Diseases Society of America
2-Jan-2004

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