BACKGROUND: The galactose elimination capacity test is a quantitative liver function test that has been shown to be a potential surrogate marker for death in advanced chronic liver diseases. However, this test lacks sensitivity in early liver disease. The goal of this study was to evaluate a [13C]-galactose breath test (GBT) in a population of patients with chronic hepatitis C. DESIGN: The GBT was performed in 10 control subjects and 50 patients with chronic hepatitis C; the results were compared with the METAVIR pathological scoring of liver biopsy specimens and with standard biochemical liver function tests. RESULTS: In 10 patients, oral vs. intravenous administration of galactose yielded similar results for the GBT (3.01% +/- 0.12% dose h-1 for oral galactose vs. 2.98 +/- 0.21 for intravenous). The GBT was then performed orally in the remaining 40 patients and 10 control subjects. A significant difference was observed between control subjects and patients (4.51% +/- 0.18% vs. 2.97% +/- 0.14% dose h-1, P < 0.0001). A significant difference for GBT results was observed between each fibrosis stage, but not with regard to the activity score. CONCLUSIONS: The GBT results are dependent on the severity of liver fibrosis in chronic hepatitis C. Further studies are needed to evaluate the usefulness of the GBT for the follow-up of chronic hepatitis C.