Hepatitis C virus RNA and hepatitis B virus DNA in serum and liver of patients with fulminant hepatitis

Gastroenterology. 1993 Feb;104(2):549-55. doi: 10.1016/0016-5085(93)90425-c.


Background: The role of hepatitis C virus (HCV) in the development of fulminant hepatitis is poorly understood.

Methods: The polymerase chain reaction was used to detect HCV RNA and hepatitis B virus (HBV) DNA in serum and liver of 40 patients with fulminant or subfulminant hepatitis.

Results: HCV RNA was detected in none of the 23 subjects with hepatitis B surface antigen (HBsAg)-negative hepatitis of unknown etiology. HBV DNA was found in 1 of these 23 subjects. In contrast, 8 of the 17 patients with HBsAg-positive hepatitis were HCV RNA positive. Among the latter, 5 had immunoglobulin (Ig) M antibody to hepatitis B core antigen (anti-HBc) and thus were acutely coinfected by HBV and HCV, whereas 3 others without IgM anti-HBc had superinfection by HCV. The active replication of HCV in the liver was shown by detection of high titers of HCV RNA and of negative-stranded HCV RNA.

Conclusion: This investigation therefore shows no evidence of a role for HCV infection in sporadic cases of fulminant hepatitis without defined etiology. However, it suggests that HCV might be implicated in a significant number of patients with HBV-related fulminant hepatitis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Base Sequence
  • DNA, Viral / analysis*
  • DNA, Viral / blood
  • Female
  • Hepacivirus / genetics*
  • Hepatic Encephalopathy / microbiology*
  • Hepatitis / microbiology*
  • Hepatitis Antibodies / analysis
  • Hepatitis B virus / genetics*
  • Humans
  • Liver / microbiology*
  • Liver / pathology
  • Male
  • Middle Aged
  • Molecular Sequence Data
  • Polymerase Chain Reaction
  • RNA, Viral / analysis*
  • RNA, Viral / blood


  • DNA, Viral
  • Hepatitis Antibodies
  • RNA, Viral