The Meaning Of Liver Biopsy For The Diagnosis And Antiviral Therapy In Chronic HCV-infected Patients With Serum HCV RNA-negative

Objective:Guiding for the diagnosis of chronic HCV infection and antiviral therapy through liver tissue virological testing for serum HCV RNA-negative patients.Methods:Between July2010and June2011,68patientas who were included because of anti-HCV positive with or without abnormal liver function and radiographic abnormalities (with splenomegaly, hepatic imbalance), or anti-HCV-negative but repeatedly abnormal liver function or radiographic abnormalities and a quantification of serum HCV RNA negative every3months in one and half year, were undertaken liver biopsies.49patientas have been diagnosed as chronic HCV infection based on the positive HCV RNA results from liver tissue virological testing. They have undertaken anti-viral therapy using pegylated interferon and and ribavirin. Related liver inflammation/fibrosis assessment and response of antiviral therapy have also been evaluated. Fully automated Beckman biochemical equipment was used to analyze the serum biochemical parameters. Real-time quantitative FQ-PCR method has been used to analyze HCV RNA content of the serum and liver tissue. SPSS16.0software was used to carry out for statistical analysis of research data.Results:Among those patients with serum HCV RNA-negative,72.1%reported of being positive in liver tissue HCV RNA tests. Patients with serum HCV RNA-negative, HCV genotype1account for55.1%;and81.6%of the infection cases were determined as CC genotype in IL-28B single nucleotide polymorphism. Compared with HCV genotype1and non-genotype1, virological response rate of liver tissue with statistical significance; compared with CC genotype and non-CC genotype, virological response rate of liver tissue with statistical significance. After having pegylated interferon and ribavirin anti-viral therapy, Knodell HAI score had an average drop of3.3points, Ishak score had an average drop of0.6points.Conclusion:Analysis of Knodell HAI inflammation and necrosis and Ishak fibrosis, and detecte of liver tissue virological simultaneously to those who are negative for anti-HCV、serum HCV RNA-negative or " Unexplained" recurrent abnormal liver function, can be more accurate diagnosis of chronic HCV infection. Analysis of liver tissue HCV RNA can be effective evaluation of the effect of pegylated interferon and ribavirin anti-viral therapy. HCV infected patients who carrying HCV genotype1and CC genotype display higher reactions of the antiviral treatment with pegylated interferon and ribavirin. Antiviral treatment can effectively improve liver inflammation and fibrosis which are caused by chronic HCV infection.