HCV in serum, peripheral blood mononuclear cells and lymphocyte subpopulations in C-hepatitis patients.

To define the best marker for the follow-up and evaluation of HCV infections we determined anti-HCV antibodies, serum transaminases and HCV RNA in patients diagnosed with chronic hepatitis for C virus and treated with alpha-interferon. The presence/absence of HCV RNA was determined in serum, peripheral blood mononuclear cells (PBMC) and lymphocyte subpopulations. Samples were submitted to RT-PCR and subsequent nested PCR. Treatment with alpha-interferon induced a fall in the number of HCV RNA positive patients from an initial 88 to 25% at the end of the treatment. The withdrawal of treatment was associated with a significant increase in the number of HCV RNA positive patients (43% at the 12-month follow-up). In 61% of the patients the PCR analysis of the PBMC population detected the presence of HCV RNA. In 87% of cases the cell fraction identified as CD19 resulted positive in the PCR test and the viral genome was undetectable in PBMC subpopulations in only 13% of cases. In one third of the patients whose serum was negative for PCR the analysis demonstrated the presence of HCV RNA in PBMC. Conclusions: The disappearance of the viral genome in serum, a criterion of treatment response, is not necessarily followed by its disappearance in PBMC. The joint determination of HCV by PCR technique in serum and blood cells should be used as a particular instrument with each patient.