Detection of hepatitis C virus RNA in sera and liver tissues of non-A, non-B hepatitis patients using the polymerase chain reaction.

Sera obtained from patients with non-A, non-B hepatitis were examined for the presence of hepatitis C virus (HCV) genome by using the reverse transcription-polymerase chain reaction assay, as well as for antibody to HCV (anti-HCV) by using an enzyme-linked immunosorbent assay (ELISA). We also examined the presence of HCV RNA in liver tissue obtained by surgical resection of hepatocellular carcinoma. Among 33 patients, HCV RNA was detectable in 21 (64%), and the antibody was also positive in 21 (64%). Eighteen (55%) patients were positive for both assays. The two assays gave inconsistent results in 3 patients who were positive for HCV RNA but negative for anti-HCV, and in 3 other patients who were negative for HCV RNA and positive for anti-HCV. HCV RNA was also detected in 6 out of 10 non-cancerous liver tissue specimens and in 3 out of 7 tumor tissue specimens. Using the polymerase chain reaction, the HCV genome was detected directly in many specimens obtained from patients with non-A, non-B hepatitis, suggesting the presence of replicating virus in patients positive for anti-HCV. In addition, the differing results of the two assay systems suggest that the application of both is important for evaluation of the status of HCV infection.